MedicaidCoverageMedium impact
Non-FDA Approved Medications (New)
Humana·LA · Pharmacy, OB-GYN·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid now excludes coverage for non-FDA approved medications by default, with exceptions only for medications specifically reviewed and approved by Humana's Pharmacy and Therapeutics Committee. The policy provides 17 alpha-hydroxyprogesterone for preterm delivery prophylaxis as an example of an approved exception.
Action Required
By October 1, 2025: Billing and pharmacy teams must verify FDA approval status before prescribing/dispensing medications to Humana Louisiana Medicaid members. Create workflow to check if non-FDA approved medications have specific Humana P&T Committee approval. Claims for non-approved medications will be denied unless specifically exempted by Humana's committee.