MedicaidPrior AuthMedium impact
Abraxane (nab-paclitaxel) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established new prior authorization requirements for Abraxane (nab-paclitaxel) for cancer treatment across six conditions: breast, lung, ovarian, pancreatic cancers and melanoma. Each indication has specific clinical criteria that must be met, with most requiring documented hypersensitivity to conventional paclitaxel or docetaxel.
Action Required
By November 1, 2025: Billing team must implement prior authorization requirements for Abraxane (nab-paclitaxel) for Indiana Medicaid patients. Update billing system to flag these cases and create provider alerts for the specific clinical criteria required for each cancer type. Providers must document hypersensitivity reactions to conventional paclitaxel/docetaxel or contraindications to standard premedication for most indications. Claims will be denied without proper prior authorization.