MedicaidPrior AuthMedium impact
Trodelvy (sacituzumab govitecan-hziy) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana is implementing prior authorization requirements for Trodelvy (sacituzumab govitecan-hziy) for treatment of triple negative breast cancer and hormone receptor positive breast cancer. This new policy establishes specific clinical criteria that must be met before coverage approval.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows for Trodelvy (sacituzumab govitecan-hziy) for Louisiana Medicaid patients. Providers must verify patients meet specific criteria including cancer type, prior therapy requirements, and treatment history before prescribing. Visit www.humana.com/PAL for medical and procedural coding information. Claims will require prior authorization approval or will be denied.