MedicaidPrior AuthMedium impact
Atezolizumab products (Tecentriq, Tecentriq Hybreza) (Revised)
Humana·OH · Oncology, Hematology, Pulmonology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has updated prior authorization requirements for atezolizumab products (Tecentriq and Tecentriq Hybreza) effective December 1, 2025. The policy establishes specific criteria for approval across multiple cancer types including lung cancer, hepatocellular carcinoma, melanoma, and sarcoma, with all approvals limited to 6-month durations.
Action Required
Before December 1, 2025: Billing team must update prior authorization processes for Tecentriq and Tecentriq Hybreza for Ohio Medicaid patients. Ensure providers document specific diagnostic criteria, PD-L1 testing results, treatment history, and combination therapy details as required by indication. All initial and renewal authorizations are limited to 6 months. Claims will be denied without proper prior authorization.