MedicaidPrior AuthMedium impact
Non-Preferred Filgrastim Products (Revised)
Humana·KY, SC · Oncology, Hematology, Infectious Disease·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid (Kentucky and South Carolina) now requires prior authorization for non-preferred filgrastim products (Neupogen, Nypozi, Releuko, Filkri) effective January 1, 2026. Patients must have failed or been intolerant to both preferred products (Zarxio and Nivestym) before these non-preferred options can be approved.
Action Required
Before January 1, 2026: Billing team must update prior authorization system to require approval for Neupogen, Nypozi, Releuko, and Filkri for Kentucky and South Carolina Medicaid patients. Providers must document previous treatment failure or intolerance to both Zarxio and Nivestym before prescribing non-preferred filgrastim products. Update encounter forms to remind providers of step therapy requirements. Claims without proper prior authorization will be denied.