MedicaidPrior AuthHigh impact
Atezolizumab products (Tecentriq, Tecentriq Hybreza) (Revised)
Humana·LA · Oncology, Hematology, Pulmonology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
New Humana Medicaid Louisiana prior authorization requirements for atezolizumab products (Tecentriq, Tecentriq Hybreza) covering multiple cancer indications including lung cancer, hepatocellular carcinoma, melanoma, and sarcoma. This policy establishes specific criteria for approval including disease staging, biomarker testing requirements, and combination therapy protocols.
Action Required
By December 1, 2025: Billing team must implement prior authorization requirements for all atezolizumab products (Tecentriq, Tecentriq Hybreza) for Louisiana Medicaid patients. Update billing system to flag these drugs and ensure providers document required criteria including cancer staging, PD-L1 expression levels, EGFR/ALK testing results, and specific combination therapy protocols. Train staff on the 7 covered indications and exclusion criteria. Claims will be denied without proper prior authorization.