MedicaidPrior AuthMedium impact
Istodax (romidepsin)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Mar 1, 2026
We identified it
Aug 12, 2026
Summary
Effective March 1, 2026, Humana Medicaid Louisiana implements a new prior authorization policy for Istodax (romidepsin) requiring coverage for cutaneous T-cell lymphoma (CTCL) treatment. Approval requires either primary biologic systemic therapy use OR at least one prior therapy. Claims will be denied if members have experienced disease progression while on romidepsin or have uncorrected potassium/magnesium levels.
Action Required
By March 1, 2026: Billing team must implement prior authorization requirement in billing system for all Istodax/romidepsin intravenous administrations for Louisiana Medicaid members. (1) Update authorization workflows to require documented proof that member meets BOTH criteria: CTCL diagnosis AND either primary biologic therapy status OR ≥1 prior systemic therapy. (2) Configure system to flag and deny claims where member has prior disease progression on romidepsin or uncorrected baseline potassium/magnesium levels. (3) Train providers and front-office staff that prior auth must be obtained BEFORE drug administration; claims submitted without approval will be denied. (4) Verify member eligibility for Louisiana Medicaid only—this policy does NOT apply to other states. (5) Refer to www.humana.com/PAL for applicable claim codes and preauthorization procedures.