MedicaidPrior AuthLow impact
Folotyn® (pralatrexate) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has implemented a new prior authorization policy for Folotyn (pralatrexate) effective January 1, 2026. This medication requires prior authorization for treatment of relapsed or refractory peripheral T-cell lymphoma, with specific criteria that must be met before approval.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for Folotyn (pralatrexate) intravenous solution for Louisiana Medicaid patients. Update billing system to flag these medications for prior auth. Providers must document that patient has relapsed or refractory peripheral T-cell lymphoma and has not experienced disease progression while on Folotyn. Visit www.humana.com/PAL for medical and procedural coding information. Claims will be denied without proper prior authorization.