MedicaidPrior AuthMedium impact
Bortezomib products (Velcade and Bortezomib for injection) (Revised)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Sep 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has revised their prior authorization policy for Bortezomib products (Velcade and generic bortezomib injections) for Indiana Medicaid members, effective September 1, 2025. The policy covers three specific cancer diagnoses (Mantle Cell Lymphoma, Multiple Myeloma, and Waldenström's Macroglobulinemia) with detailed approval criteria and exclusions for disease progression while on bortezomib-containing regimens.
Action Required
Before September 1, 2025: Billing team and oncology providers must update prior authorization procedures for Bortezomib products (Velcade and generic bortezomib injections) for Indiana Medicaid patients. Verify patient diagnosis matches approved indications (Mantle Cell Lymphoma, Multiple Myeloma, or Waldenström's Macroglobulinemia) and confirm no disease progression on previous bortezomib-containing regimens before submitting PA requests. Update encounter forms to capture required clinical criteria. Claims without proper prior authorization will be denied.