MedicaidPrior AuthMedium impact
Beleodaq® (belinostat)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Aug 12, 2026
Summary
Humana Indiana Medicaid is implementing a new prior authorization policy for Beleodaq (belinostat) effective January 1, 2026, for treatment of relapsed or refractory peripheral T-cell lymphoma (PTCL). All Beleodaq prescriptions require prior authorization with initial and renewal approvals valid for 6 months. Claims must meet specific clinical criteria and cannot be approved if the member has experienced disease progression on Beleodaq or is concurrently on romidepsin, vorinostat, or pralatrexate.
Action Required
By December 31, 2025: Billing team and providers must implement the following: (1) Update billing system to require prior authorization for all Beleodaq (belinostat) intravenous solution prescriptions for Indiana Medicaid members; (2) Configure system to validate that member diagnosis is relapsed or refractory PTCL before allowing claim submission; (3) Add system logic to flag and deny claims if member has history of disease progression on Beleodaq or is on concomitant Istodax, Zolinza, or Folotyn therapy; (4) Establish 6-month approval tracking in billing system to monitor initial and renewal authorization periods; (5) Train providers and billing staff on submission requirements and contraindications; (6) Update prior authorization request templates to include mandatory fields: diagnosis confirmation, treatment history, and current concomitant medications. Billing team responsible for system updates and claim processing. Providers responsible for documentation. Failure to obtain prior authorization before billing will result in claim denials.