Medicare AdvantagePrior AuthMedium impact
Columvi™ (glofitamab-gxbm) (Revised)
Humana·FL, KY, SC · Oncology, Hematology·Medicaid
Effective date
Feb 25, 2026
We identified it
Jun 25, 2026
Summary
Humana revised its Columvi (glofitamab-gxbm) prior authorization policy effective February 25, 2026, covering Medicare and Medicaid plans in Florida, Kentucky, and South Carolina. The policy maintains prior authorization requirements for this bispecific antibody used to treat relapsed/refractory diffuse large B-cell lymphoma in patients who have received two or more prior systemic therapies. No substantive coverage criteria changes are noted; this appears to be a routine policy review and update.
Action Required
By February 25, 2026: Billing team must ensure prior authorization processes are activated in the billing system for Columvi (glofitamab-gxbm) intravenous solution for the affected plans (Medicare, Medicaid-Florida, Medicaid-Kentucky, Medicaid-South Carolina). Verify that the system validates the three approval criteria before claim submission: (1) diagnosis of DLBCL, NOS or LBCL from follicular lymphoma, (2) two or more prior systemic therapy lines, and (3) use as monotherapy. Confirm that disease progression on prior Columvi therapy triggers automatic denial. Update internal documentation to reference the February 25, 2026 revision date. Failure to obtain prior authorization will result in claim denials.