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MedicaidPrior AuthMedium impact

Imjudo (tremelimumab-actl) (New)

Humana·LA · Oncology, Hematology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Louisiana Medicaid has established a new prior authorization policy for Imjudo (tremelimumab-actl), a cancer immunotherapy drug used to treat unresectable hepatocellular carcinoma and metastatic non-small cell lung cancer. Prior authorization will be required for all Imjudo treatments, with specific criteria including combination therapy requirements and genomic testing results.

Action Required

Action needed
Before December 1, 2025: Billing team must implement prior authorization requirements for Imjudo (tremelimumab-actl) treatments for Louisiana Medicaid patients. Update billing system to flag cases requiring prior auth for hepatocellular carcinoma and non-small cell lung cancer treatments. Providers must document unresectable diagnosis, combination therapy plans with Imfinzi, and genomic testing results where applicable. Claims without prior authorization will be denied.