MedicaidPrior AuthMedium impact
Bortezomib products (Velcade and Bortezomib for injection) (Revised)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Sep 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has revised their prior authorization policy for bortezomib products (Velcade and generic bortezomib injections) effective September 1, 2025. The policy covers three conditions: Mantle Cell Lymphoma, Multiple Myeloma, and Waldenström's Macroglobulinemia, with specific criteria and exclusions for each indication.
Action Required
By September 1, 2025: Clinical staff must ensure prior authorization is obtained for all bortezomib products (Velcade and generic bortezomib injections) for Ohio Medicaid patients. Verify patient meets diagnosis criteria for Mantle Cell Lymphoma, Multiple Myeloma, or Waldenström's Macroglobulinemia and confirm no disease progression on previous bortezomib-containing regimens. Update prior authorization request processes to include required clinical documentation for approval.