MedicaidPrior AuthMedium impact
Amivantamab Products (Rybrevant, Rybrevant Faspro) (Revised)
Humana·OH · Oncology·Medicaid
Effective date
Jul 23, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has updated prior authorization criteria for Amivantamab cancer drugs (Rybrevant and Rybrevant Faspro) used to treat non-small cell lung cancer. The policy now covers four specific treatment scenarios based on EGFR mutation types and includes new combination therapies with lazertinib.
Action Required
By July 23, 2025: Billing team must update prior authorization protocols for Amivantamab products (Rybrevant/Rybrevant Faspro) to include new coverage criteria for EGFR exon 19 deletions and exon 21 L858R mutations. Ensure oncology providers document specific EGFR mutation types via FDA-approved testing and treatment line requirements. Verify member eligibility for Ohio Medicaid before submitting requests.