MedicaidPrior AuthMedium impact
Atezolizumab products (Tecentriq, Tecentriq Hybreza) (Revised)
Humana·IN · Oncology, Hematology, Pulmonology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has revised its prior authorization policy for atezolizumab products (Tecentriq and Tecentriq Hybreza) for Indiana Medicaid patients. The policy establishes specific criteria and exclusions for coverage across multiple cancer types including non-small cell lung cancer, small cell lung cancer, hepatocellular carcinoma, melanoma, and alveolar soft part sarcoma.
Action Required
By December 1, 2025: Billing team must ensure prior authorization is obtained for all Tecentriq and Tecentriq Hybreza requests for Indiana Medicaid patients. Providers must document specific diagnostic criteria, PD-L1 testing results where required, and confirm no prior disease progression on anti-PD-1/PD-L1 therapy. Update prior authorization tracking system to monitor 6-month approval durations and renewal requirements.