MedicaidPrior AuthMedium impact
Istodax (romidepsin)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Mar 1, 2026
We identified it
Aug 12, 2026
Summary
Humana Medicaid Indiana implemented a new Prior Authorization policy for Istodax (romidepsin) effective March 1, 2026. The policy requires prior authorization for romidepsin IV infusion used to treat cutaneous T-cell lymphoma, with coverage limited to patients using it as primary biologic systemic therapy OR those with at least one prior therapy. Patients with disease progression on romidepsin are excluded from coverage.
Action Required
By March 1, 2026: Billing and clinical teams must implement prior authorization requirements for all Istodax (romidepsin) IV infusion claims for Humana Medicaid Indiana members. Specifically: (1) Verify patient meets coverage criteria before billing—confirm CTCL diagnosis AND either primary biologic systemic therapy use OR documented prior systemic therapy; (2) Confirm patient does NOT have documented disease progression on romidepsin; (3) Submit prior authorization requests through Humana's PAL (Preauthorization and Notification List) system at www.humana.com/PAL before dispensing; (4) Update EMR/billing system to flag romidepsin prescriptions for this plan requiring prior auth; (5) Educate providers that claims submitted without prior authorization will be denied. Clinical teams must also verify baseline potassium/magnesium levels are corrected before treatment and screen for CYP3A4 drug interactions per prescribing information.