MedicaidPrior AuthMedium impact
Emrelis (telisotuzumab vedotin-tllv) (Revised)
Humana·LA · Oncology, Pulmonology·Medicaid
Effective date
Sep 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Emrelis (telisotuzumab vedotin-tllv), a cancer drug for treating specific types of non-small cell lung cancer. The policy requires strict eligibility criteria including cancer staging, protein expression testing, and previous therapy documentation before approval.
Action Required
By September 1, 2025: Oncology billing team must implement prior authorization requirements for Emrelis (telisotuzumab vedotin-tllv) for Louisiana Medicaid patients. Update billing system to flag this drug for prior auth. Providers must document: locally advanced or metastatic non-squamous EGFR wild-type NSCLC diagnosis, high c-Met protein overexpression test results (≥50% tumor cells with 3+ staining via FDA-approved test), previous systemic therapy history, and confirm monotherapy use. Claims will be denied without proper authorization.