MedicaidPrior AuthMedium impact
Tivdak (tisotumab vedotin-tftv) (New)
Humana·OH · Oncology, OB-GYN·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Tivdak (tisotumab vedotin-tftv), a cancer treatment for recurrent or metastatic cervical cancer. Prior authorization is required before administering this medication, with specific criteria including disease progression after chemotherapy and administration as monotherapy.
Action Required
Before October 1, 2025: Billing team must update prior authorization requirements for Tivdak (tisotumab vedotin-tftv) in billing system for Humana Medicaid Ohio patients. Providers must verify patient meets all four criteria (recurrent/metastatic cervical cancer, disease progression after chemotherapy, medical reason why Keytruda cannot be used if CPS score ≥1, and monotherapy administration) before treatment. Obtain prior authorization through Humana's system before administering. Claims will be denied without proper authorization.