MedicaidPrior AuthMedium impact
Tivdak (tisotumab vedotin-tftv) (Revised)
Humana·LA · Oncology, OB-GYN·Medicaid
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has revised their prior authorization policy for Tivdak (tisotumab vedotin-tftv), a cancer drug for recurrent/metastatic cervical cancer. The policy establishes specific criteria including disease progression after chemotherapy and requires that Keytruda cannot be used if CPS score is ≥1.
Action Required
Immediately: Billing team must verify prior authorization is obtained for all Tivdak (tisotumab vedotin-tftv) claims for Louisiana Medicaid patients. Ensure providers document all four criteria: recurrent/metastatic cervical cancer, disease progression after chemotherapy, medical reason Keytruda cannot be used (if CPS ≥1), and that Tivdak is used as monotherapy. Claims will be denied without proper prior authorization.