MedicaidPrior AuthMedium impact
Liposomal doxorubicin (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Oct 22, 2025
We identified it
Jun 24, 2026
Summary
Humana Ohio Medicaid has established a new prior authorization policy for liposomal doxorubicin (Doxil, Lipodox) effective October 22, 2025. The policy covers six cancer indications with specific criteria for approval including diagnosis requirements, combination therapy specifications, and treatment line restrictions.
Action Required
By October 22, 2025: Billing team must implement prior authorization requirements for all liposomal doxorubicin products (Doxil, Lipodox) for Ohio Medicaid members. Update system to flag these medications and ensure providers obtain prior auth based on specific diagnosis criteria for Non-Hodgkin's lymphoma, breast cancer, Hodgkin lymphoma, Kaposi's sarcoma, multiple myeloma, and ovarian cancer. Visit www.humana.com/PAL for medical coding information. Claims will be denied without proper prior authorization.