MedicaidPrior AuthMedium impact
Cyramza (ramucirumab) (Revised)
Humana·KY, SC · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has revised their prior authorization policy for Cyramza (ramucirumab), an IV cancer treatment drug. The policy details specific coverage criteria for six cancer types including esophageal, colorectal, lung, gastric, and liver cancers, with requirements for prior therapy failures and specific combination treatments.
Action Required
Immediately: Billing and clinical teams must review updated prior authorization criteria for Cyramza (ramucirumab) for Medicaid patients in Kentucky and South Carolina. Ensure documentation includes specific cancer diagnosis, prior treatment history, and combination therapy details before submitting authorization requests. Verify patient meets all criteria including disease progression requirements and biomarker testing results where applicable.