MedicaidPrior AuthMedium impact
Bizengri (zenocutuzumab-zbco) (New)
Humana·LA · Oncology, Pulmonology, Gastroenterology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Bizengri (zenocutuzumab-zbco), a new cancer drug for treating NRG1 gene fusion positive non-small cell lung cancer and pancreatic adenocarcinoma. Prior authorization will be required for Louisiana Medicaid members starting January 1, 2026, with specific criteria including advanced/metastatic disease, genetic testing confirmation, and previous systemic therapy.
Action Required
Before January 1, 2026: Billing and clinical teams must implement prior authorization requirements for Bizengri (zenocutuzumab-zbco) for Louisiana Medicaid patients. Update billing system to flag this medication for prior auth. Providers must document advanced/unresectable/metastatic disease, NRG1 gene fusion positive status, previous systemic therapy, and confirm monotherapy use. Visit www.humana.com/PAL for specific billing codes and preauthorization requirements.