MedicaidPrior AuthMedium impact
Palonosetron IV (Aloxi generics) (Revised)
Humana·SC · Oncology, Critical Care, Gastroenterology·Medicaid
We identified it
Jul 2, 2026
Summary
Humana has revised its Prior Authorization policy for Palonosetron IV (Aloxi generics) for South Carolina Medicaid members. This is a 1-day-old policy update requiring immediate review to determine specific authorization requirements and any billing workflow changes needed for this anti-nausea medication.
Action Required
Immediately: Billing team must obtain and review the complete Palonosetron IV (Aloxi generics) Prior Authorization policy from Humana (URL: https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5e0). Determine specific authorization triggers, documentation requirements, and clinical criteria. Update billing system to flag claims for CPT J2469 requiring prior auth before submission to Humana South Carolina Medicaid. Notify providers of any new authorization requirements. Claims submitted without required prior authorization will be denied.