MedicaidPrior AuthHigh impact
Liposomal doxorubicin (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Oct 22, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for liposomal doxorubicin (Doxil, Lipodox) covering six cancer indications with specific clinical criteria. This chemotherapy drug now requires pre-approval with detailed diagnosis and treatment combination requirements.
Action Required
By October 22, 2025: Billing team must implement prior authorization requirements for all liposomal doxorubicin products (Doxil, Lipodox) for Ohio Medicaid patients. Update billing system to flag these drugs for pre-approval. Providers must document specific diagnosis criteria and treatment combinations as outlined in the policy before administration. Claims will be denied without proper prior authorization.