MedicaidPrior AuthMedium impact
Levoleucovorin products (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Sep 24, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented a new prior authorization policy for levoleucovorin products (Fusilev and Khapzory) effective September 24, 2025. Coverage requires patients to have tried leucovorin calcium first and experienced documented side effects or lack of efficacy for three specific conditions: osteosarcoma, methotrexate toxicity, and advanced metastatic colorectal cancer.
Action Required
By September 24, 2025: For Ohio Medicaid patients needing levoleucovorin products (Fusilev, Khapzory), billing team must obtain prior authorization by documenting: 1) Previous leucovorin calcium treatment, 2) Documented side effects or lack of efficacy with leucovorin calcium, 3) Qualifying diagnosis (osteosarcoma with high-dose methotrexate, methotrexate toxicity, or advanced metastatic colorectal cancer with 5-fluorouracil). Update prior auth checklists and alert oncology providers. Claims will be denied without proper prior authorization.