MedicaidPrior AuthMedium impact
Jevtana® (cabazitaxel) (Revised)
Humana·IN · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has revised its Prior Authorization policy for Jevtana® (cabazitaxel) for Indiana Medicaid members. This is a drug-specific prior authorization update that may affect coverage requirements, approval criteria, or documentation needs for this chemotherapy agent. The billing team must review the full policy details to understand specific authorization requirements and implement necessary workflow changes.
Action Required
Immediately: Obtain and review the complete Jevtana® (cabazitaxel) Prior Authorization policy from Humana Indiana Medicaid at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584843. Billing team and oncology providers must: (1) Identify specific prior authorization requirements (diagnosis, dosage, line of therapy, documentation needed); (2) Update billing software to require prior authorization for HCPCS code J9043 for Indiana Medicaid claims; (3) Create or revise prior authorization request templates and checklists; (4) Train providers and billing staff on new requirements; (5) Update encounter forms and EMR templates to prompt for prior authorization before claim submission. Establish a process to track authorization status. Claims for Jevtana® submitted without required prior authorization will be denied, resulting in revenue loss and potential patient billing issues.