MedicaidPrior AuthMedium impact
Beleodaq® (belinostat)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Aug 12, 2026
Summary
Humana Medicaid Ohio implemented a new prior authorization policy for Beleodaq (belinostat) effective January 1, 2026. The policy requires prior authorization for belinostat treatment in patients with relapsed or refractory peripheral T-cell lymphoma (PTCL), with specific approval criteria, two key exclusions (disease progression on Beleodaq or concurrent use of other HDAC inhibitors), and 6-month initial and renewal approval periods.
Action Required
By December 31, 2025: Billing team must implement prior authorization workflow for Beleodaq (J9018) for all Ohio Medicaid members. (1) Update billing system to flag J9018 claims as requiring prior auth before submission. (2) Notify oncology providers that Beleodaq now requires PA with verification of: relapsed/refractory PTCL diagnosis, no prior disease progression on Beleodaq, and no concomitant HDAC inhibitor therapy (Istodax, Zolinza, Folotyn). (3) Create PA request template including hematologic monitoring requirements (ANC >1.0 x 10^9/L, platelets ≥50 x 10^9/L), liver function testing, and UGT1A1*28 polymorphism status if available. (4) Set system reminders for 6-month renewal authorization. Claims submitted without prior authorization will be denied. Staff should reference Humana's PAL portal at www.humana.com/PAL for medical coding requirements.