MedicaidPrior AuthMedium impact
Trodelvy (sacituzumab govitecan-hziy) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid (Indiana) has established a new prior authorization policy for Trodelvy (sacituzumab govitecan-hziy) intravenous solution, effective January 1, 2026. This policy covers treatment for triple negative breast cancer and hormone receptor positive breast cancer with specific clinical criteria that must be met for approval.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for Trodelvy (sacituzumab govitecan-hziy) intravenous solution for Humana Medicaid Indiana members. Providers must document that patients meet specific criteria including cancer type, prior therapies received, and treatment history. Visit www.humana.com/PAL for medical and procedural coding information. Claims without prior authorization will be denied.