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| Item Number | Policy/Procedure | Date Posted | Comment Period Closed | Status | Document Links |
|---|---|---|---|---|---|
| 2026-LHCC-MED-948 | Afamelanotide (Scenesse) | 3/18/26 | 5/2/26 | Complete | Afamelanotide (Scenesse) |
| 2026-LHCC-MED-949 | Brolucizumab-dbll (Beovu) | 3/18/26 | 5/2/26 | Complete | Brolucizumab-dbll (Beovu) |
| 2026-LHCC-MED-950 | Avalglucosidase Alfa-ngpt (Nexviazyme) | 3/18/26 | 5/2/26 | Complete | Avalglucosidase Alfa-ngpt (Nexviazyme) |
| 2026-LHCC-MED-951 | Margetuximab-cmkb (Margenza) | 3/18/26 | 5/2/26 | Complete | Margetuximab-cmkb (Margenza) |
| 2026-LHCC-MED-952 | Naxitamab-gqgk (Danyelza) | 3/18/26 | 5/2/26 | Complete | Naxitamab-gqgk (Danyelza) |
| 2026-LHCC-MED-953 | Ropeginterferon Alfa-2b-njft (BESREMi) | 3/18/26 | 5/2/26 | Complete | Ropeginterferon Alfa-2b-njft (BESREMi) |
| 2026-LHCC-MED-954 | Sirolimus Protein-Bound Particles (Fyarro) | 3/18/26 | 5/2/26 | Complete | Sirolimus Protein-Bound Particles (Fyarro) |
| 2026-LHCC-MED-955 | Interferon Gamma-1b (Actimmune) | 3/18/26 | 5/2/26 | Complete | Interferon Gamma-1b (Actimmune) |
| 2026-LHCC-MED-956 | Faricimab-svoa (Vabysmo) | 3/18/26 | 5/2/26 | Complete | Faricimab-svoa (Vabysmo) |
| 2026-LHCC-MED-957 | Alpha1-Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) | 3/18/26 | 5/2/26 | Complete | Alpha1-Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) |
| 2026-LHCC-MED-958 | Zilucoplan (Zilbrysq) | 3/18/26 | 5/2/26 | Complete | Zilucoplan (Zilbrysq) |
| 2026-LHCC-MED-959 | Ferric Carboxymaltose (Injectafer) | 3/18/26 | 5/2/26 | Complete | Ferric Carboxymaltose (Injectafer) |
| 2026-LHCC-MED-960 | Bortezomib (Velcade) | 3/18/26 | 5/2/26 | Complete | Bortezomib (Velcade) |
| 2026-LHCC-MED-961 | Cosibelimab-Ipdl (Unloxcyt) | 3/18/26 | 5/2/26 | Complete | Cosibelimab-Ipdl (Unloxcyt) |
| 2026-LHCC-MED-962 | Zenocutuzumab-zbco (Bizengri) | 3/18/26 | 5/2/26 | Complete | Zenocutuzumab-zbco (Bizengri) |
| 2026-LHCC-MED-944 | Lisocabtagene Maraleucel (Breyanzi) | 3/18/26 | 5/2/26 | Complete | Lisocabtagene Maraleucel (Breyanzi) |
| 2026-LHCC-MED-945 | Lifileucel (Amtagvi) | 3/18/26 | 5/2/26 | Complete | Lifileucel (Amtagvi) |
| 2026-LHCC-MED-946 | Obecabtagene autoleucel (Aucatzyl) | 3/18/26 | 5/2/26 | Complete | Obecabtagene autoleucel (Aucatzyl) |
| 2026-LHCC-MED-947 | Axicabtagene ciloleucel (Yescarta) | 3/18/26 | 5/2/26 | Complete | Axicabtagene ciloleucel (Yescarta) |
| 2026-LHCC-MED-939 | Aflibercept (Eylea, Eylea HD) and Biosimilars) | 3/17/26 | 5/1/26 | Complete | Aflibercept (Eylea, Eylea HD) and Biosimilars) |
| 2026-LHCC-MED-940 | Mosunetuzumab-axgb (Lunsumio) | 3/17/26 | 5/1/26 | Complete | Mosunetuzumab-axgb (Lunsumio) |
| 2026-LHCC-MED-941 | Hemin (Panhematin) | 3/17/26 | 5/1/26 | Complete | Hemin (Panhematin) |
| 2026-LHCC-MED-942 | Emapalumab-lzsg (Gamifant) | 3/17/26 | 5/1/26 | Complete | Emapalumab-lzsg (Gamifant) |
| 2026-LHCC-MED-943 | Pembrolizumab, Pembrolizumab-Berahyaluronidase Alfa-pmph (Keytruda, Keytruda Qlex) | 3/17/26 | 5/1/26 | Complete | Pembrolizumab, Pembrolizumab-Berahyaluronidase Alfa-pmph (Keytruda, Keytruda Qlex) |
| 2026-HB-MED-666 | Aliqopa (copanlisib) | 3/12/26 | 4/26/26 | Complete | Aliqopa (copanlisib) |
| 2026-HB-MED-667 | Tecartus (brexucabtagene autoleucel) | 3/12/26 | 4/26/26 | Complete | Tecartus (brexucabtagene autoleucel) |
| 2026-HB-MED-668 | Besremi (ropeginterferon alfa-2b-njft) | 3/12/26 | 4/26/26 | Complete | Besremi (ropeginterferon alfa-2b-njft) |
| 2026-HB-MED-670 | Tecvayli (teclistamab-cqyv) | 3/12/26 | 4/26/26 | Complete | Tecvayli (teclistamab-cqyv) |
| 2026-HB-MED-671 | Imjudo (tremelimumab-actl) | 3/12/26 | 4/26/26 | Complete | Imjudo (tremelimumab-actl) |
| 2026-HB-MED-672 | Talvey (talquetamab-tgvs) | 3/12/26 | 4/26/26 | Complete | Talvey (talquetamab-tgvs) |
| 2026-HB-MED-673 | Loqtorzi (toripalimab-tpzi) | 3/12/26 | 4/26/26 | Complete | Loqtorzi (toripalimab-tpzi) |
| 2026-HB-MED-674 | Aucatzyl (obecabtagene autoleucel) | 3/12/26 | 4/26/26 | Complete | Aucatzyl (obecabtagene autoleucel) |
| 2026-HB-MED-675 | Ziihera (zanidatamab-hrii) | 3/12/26 | 4/26/26 | Complete | Ziihera (zanidatamab-hrii) |
| 2026-HB-MED-656 | Forzinity (elamipretide) | 3/12/26 | 4/26/26 | Complete | Forzinity (elamipretide) |
| 2026-HB-MED-657 | Ethyol (amifostine) | 3/12/26 | 4/26/26 | Complete | Ethyol (amifostine) |
| 2026-HB-MED-658 | Fyarro (sirolimus albumin bound) | 3/12/26 | 4/26/26 | Complete | Fyarro (sirolimus albumin bound) |
| 2026-HB-MED-659 | Elrexfio (elranatamab-bcmm) | 3/12/26 | 4/26/26 | Complete | Elrexfio (elranatamab-bcmm) |
| 2026-HB-MED-660 | Radicava (edaravone) | 3/12/26 | 4/26/26 | Complete | Radicava (edaravone) |
| 2026-HB-MED-661 | Vascular Endothelial Growth Factor (VEGF) Inhibitors | 3/12/26 | 4/26/26 | Complete | Vascular Endothelial Growth Factor (VEGF) Inhibitors |
| 2026-HB-MED-662 | Alpha-1 Proteinase Inhibitor Therapy | 3/12/26 | 4/26/26 | Complete | Alpha-1 Proteinase Inhibitor Therapy |
| 2026-HB-MED-663 | Bendamustine agents | 3/12/26 | 4/26/26 | Complete | Bendamustine agents |
| 2026-HB-MED-664 | Kyprolis (carfilzomib) | 3/12/26 | 4/26/26 | Complete | Kyprolis (carfilzomib) |
| 2026-HB-MED-665 | Keytruda (pembrolizumab) | 3/12/26 | 4/26/26 | Complete | Keytruda (pembrolizumab) |
| 2026-LHCC-MED-927 | Ibandronate Injection (Boniva) | 3/5/26 | 4/19/26 | Complete | Ibandronate Injection (Boniva) |
| 2026-LHCC-MED-928 | Panitumumab (Vectibix) | 3/5/26 | 4/19/26 | Complete | Panitumumab (Vectibix) |
| 2026-LHCC-MED-929 | Durvalumab (Imfinzi) | 3/5/26 | 4/19/26 | Complete | Durvalumab (Imfinzi) |
| 2026-LHCC-MED-930 | Tislelizumab-jsgr (Tevimbra) | 3/5/26 | 4/19/26 | Complete | Tislelizumab-jsgr (Tevimbra) |
| 2026-LHCC-MED-931 | Cetuximab (Erbitux) | 3/5/26 | 4/19/26 | Complete | Cetuximab (Erbitux) |
| 2026-LHCC-MED-932 | Inotersen (Tegsedi) | 3/5/26 | 4/19/26 | Complete | Inotersen (Tegsedi) |
| 2026-LHCC-MED-933 | Agalsidase Beta (Fabrazyme) | 3/5/26 | 4/19/26 | Complete | Agalsidase Beta (Fabrazyme) |
| 2026-LHCC-MED-934 | Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne, Mvasi, Vegzelma, Zirabev) | 3/5/26 | 4/19/26 | Complete | Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne, Mvasi, Vegzelma, Zirabev) |
| 2026-LHCC-MED-935 | Epcoritamab-bysp (Epkinly) | 3/5/26 | 4/19/26 | Complete | Epcoritamab-bysp (Epkinly) |
| 2026-LHCC-MED-936 | Ferumoxytol (Feraheme) | 3/5/26 | 4/19/26 | Complete | Ferumoxytol (Feraheme) |
| 2026-LHCC-MED-937 | Off-Label Use | 3/5/26 | 4/19/26 | Complete | Off-Label Use |
| 2026-LHCC-MED-938 | No Coverage Criteria | 3/5/26 | 4/19/26 | Complete | No Coverage Criteria |
| 2026-LHCC-MED-924 | Hyaluronate Derivatives | 3/4/26 | 4/18/26 | Complete | Hyaluronate Derivatives |
| 2026-LHCC-MED-925 | Mitomycin Instillation Solution (Jelmyto, Zusduri) | 3/4/26 | 4/18/26 | Complete | Mitomycin Instillation Solution (Jelmyto, Zusduri) |
| 2026-LHCC-MED-926 | Nipocalimab-aahu (Imaavy) | 3/4/26 | 4/18/26 | Complete | Nipocalimab-aahu (Imaavy) |
| 2026-LHCC-MED-918 | Elotuzumab (Empliciti) | 3/4/26 | 4/18/26 | Complete | Elotuzumab (Empliciti) |
| 2026-LHCC-MED-919 | Tarlatamab-dlle (Imdelltra) | 3/4/26 | 4/18/26 | Complete | Tarlatamab-dlle (Imdelltra) |
| 2026-LHCC-MED-920 | Parathyroid hormone (Natpara) | 3/4/26 | 4/18/26 | Complete | Parathyroid hormone (Natpara) |
| 2026-LHCC-MED-921 | Trofinetide (Daybue, Daybue Stix) | 3/4/26 | 4/18/26 | Complete | Trofinetide (Daybue, Daybue Stix) |
| 2026-LHCC-MED-922 | Idecabtagene Vicleucel (Abecma) | 3/4/26 | 4/18/26 | Complete | Idecabtagene Vicleucel (Abecma) |
| 2026-LHCC-MED-923 | Afamitresgene Autoleucel (Tecelra) | 3/4/26 | 4/18/26 | Complete | Afamitresgene Autoleucel (Tecelra) |
| 2026-ACLA-MED-129 | Papzimeos | 2/27/26 | 4/13/26 | Complete | Papzimeos |
| 2026-LHCC-MED-904 | Valrubicin (Valstar) | 2/9/26 | 3/26/26 | Complete | Valrubicin (Valstar) |
| 2026-LHCC-MED-905 | Tafasitamab-cxix (Monjuvi) | 2/9/26 | 3/26/26 | Complete | Tafasitamab-cxix (Monjuvi) |
| 2026-LHCC-MED-906 | Irinotecan Liposome (Onivyde) | 2/9/26 | 3/26/26 | Complete | Irinotecan Liposome (Onivyde) |
| 2026-LHCC-MED-907 | Levoleucovorin (Fusilev, Khapzory) | 2/9/26 | 3/26/26 | Complete | Levoleucovorin (Fusilev, Khapzory) |
| 2026-LHCC-MED-908 | Eribulin Mesylate (Halaven) | 2/9/26 | 3/26/26 | Complete | Eribulin Mesylate (Halaven) |
| 2026-LHCC-MED-909 | Daunorubicin/Cytarabine (Vyxeos) | 2/9/26 | 3/26/26 | Complete | Daunorubicin/Cytarabine (Vyxeos) |
| 2026-LHCC-MED-910 | Leucovorin Injection | 2/9/26 | 3/26/26 | Complete | Leucovorin Injection |
| 2026-LHCC-MED-911 | Tofersen (Qalsody) | 2/9/26 | 3/26/26 | Complete | Tofersen (Qalsody) |
| 2026-LHCC-MED-912 | Obinutuzumab (Gazyva) | 2/9/26 | 3/26/26 | Complete | Obinutuzumab (Gazyva) |
| 2026-LHCC-MED-913 | Pralatrexate (Folotyn) | 2/9/26 | 3/26/26 | Complete | Pralatrexate (Folotyn) |
| 2026-LHCC-MED-914 | Antithymocyte Globulin (Atgam, Thymoglobulin) | 2/9/26 | 3/26/26 | Complete | Antithymocyte Globulin (Atgam, Thymoglobulin) |
| 2026-LHCC-MED-915 | Inotuzumab Ozogamicin (Besponsa) | 2/9/26 | 3/26/26 | Complete | Inotuzumab Ozogamicin (Besponsa) |
| 2026-LHCC-MED-916 | Tisotumab Vedotin-tftv (Tivdak) | 2/9/26 | 3/26/26 | Complete | Tisotumab Vedotin-tftv (Tivdak) |
| 2026-LHCC-MED-917 | Ofatumumab (Arzerra) | 2/9/26 | 3/26/26 | Complete | Ofatumumab (Arzerra) |
| 2026-LHCC-MED-886 | Avacincaptad pegol (Izervay) | 2/9/26 | 3/26/26 | Complete | Avacincaptad pegol (Izervay) |
| 2026-LHCC-MED-887 | Asfotase Alfa (Strensiq) | 2/9/26 | 3/26/26 | Complete | Asfotase Alfa (Strensiq) |
| 2026-LHCC-MED-888 | Azacitidine (Onureg, Vidaza) | 2/9/26 | 3/26/26 | Complete | Azacitidine (Onureg, Vidaza) |
| 2026-LHCC-MED-889 | Ravulizumab-cwvz (Ultomiris) | 2/9/26 | 3/26/26 | Complete | Ravulizumab-cwvz (Ultomiris) |
| 2026-LHCC-MED-890 | Cetuximab (Erbitux) | 2/9/26 | 3/26/26 | Complete | Cetuximab (Erbitux) |
| 2026-LHCC-MED-891 | Carfilzomib (Kyprolis) | 2/9/26 | 3/26/26 | Complete | Carfilzomib (Kyprolis) |
| 2026-LHCC-MED-892 | Bendamustine (Belrapzo, Bendeka, Treanda, Vivimusta) | 2/9/26 | 3/26/26 | Complete | Bendamustine (Belrapzo, Bendeka, Treanda, Vivimusta) |
| 2026-LHCC-MED-893 | Rozanolixizumab-noli (Rystiggo) | 2/9/26 | 3/26/26 | Complete | Rozanolixizumab-noli (Rystiggo) |
| 2026-LHCC-MED-894 | Talquetamab-tgvs (Talvey) | 2/9/26 | 3/26/26 | Complete | Talquetamab-tgvs (Talvey) |
| 2026-LHCC-MED-895 | Elranatamab-bcmm (Elrexfio) | 2/9/26 | 3/26/26 | Complete | Elranatamab-bcmm (Elrexfio) |
| 2026-LHCC-MED-896 | Melphalan (Hepzato) | 2/9/26 | 3/26/26 | Complete | Melphalan (Hepzato) |
| 2026-LHCC-MED-873 | Mogamulizumab-kpkc (Poteligeo) | 2/9/26 | 3/26/26 | Complete | Mogamulizumab-kpkc (Poteligeo) |
| 2026-LHCC-MED-874 | Pasireotide (Signifor, Signifor LAR) | 2/9/26 | 3/26/26 | Complete | Pasireotide (Signifor, Signifor LAR) |
| 2026-LHCC-MED-875 | Pegvisomant (Somavert) | 2/9/26 | 3/26/26 | Complete | Pegvisomant (Somavert) |
| 2026-LHCC-MED-876 | Lanreotide (Somatuline Depot) | 2/9/26 | 3/26/26 | Complete | Lanreotide (Somatuline Depot) |
| 2026-LHCC-MED-877 | Belatacept (Nulojix) | 2/9/26 | 3/26/26 | Complete | Belatacept (Nulojix) |
| 2026-LHCC-MED-878 | Necitumumab (Portrazza) | 2/9/26 | 3/26/26 | Complete | Necitumumab (Portrazza) |
| 2026-LHCC-MED-879 | Ziv-aflibercept (Zaltrap) | 2/9/26 | 3/26/26 | Complete | Ziv-aflibercept (Zaltrap) |
| 2026-LHCC-MED-880 | Plasminogen, Human-tvmh (Ryplazim) | 2/9/26 | 3/26/26 | Complete | Plasminogen, Human-tvmh (Ryplazim) |
| 2026-LHCC-MED-881 | Belinostat (Beleodaq) | 2/9/26 | 3/26/26 | Complete | Belinostat (Beleodaq) |
| 2026-LHCC-MED-882 | Romidepsin (Istodax) | 2/9/26 | 3/26/26 | Complete | Romidepsin (Istodax) |
| 2026-LHCC-MED-883 | Temsirolimus (Torisel) | 2/9/26 | 3/26/26 | Complete | Temsirolimus (Torisel) |
| 2026-LHCC-MED-884 | Pegaspargase (Oncaspar), Calaspargase Pegol-mknl | 2/9/26 | 3/26/26 | Complete | Pegaspargase (Oncaspar), Calaspargase Pegol-mknl |
| 2026-LHCC-MED-885 | Denileukin Diftitox-cxdl (Lymphir) | 2/9/26 | 3/26/26 | Complete | Denileukin Diftitox-cxdl (Lymphir) |
| 2026-LHCC-MED-872 | Zopapogene Imadenovec (Papzimeos) | 2/6/26 | 3/23/26 | Complete | Zopapogene Imadenovec (Papzimeos) |
| 2026-LHCC-MED-897 | Brexucabtagene Autoleucel (Tecartus) | 2/6/26 | 3/23/26 | Complete | Brexucabtagene Autoleucel (Tecartus) |
| 2026-LHCC-MED-898 | Talimogene laherepvec (Imlygic) | 2/6/26 | 3/23/26 | Complete | Talimogene laherepvec (Imlygic) |
| 2026-LHCC-MED-899 | Trastuzumab/Biosimilars, Trastuzumab-Hyaluronidase | 2/6/26 | 3/23/26 | Complete | Trastuzumab/Biosimilars, Trastuzumab-Hyaluronidase |
| 2026-LHCC-MED-900 | Atezolizumab (Tecentriq) | 2/6/26 | 3/23/26 | Complete | Atezolizumab (Tecentriq) |
| 2026-LHCC-MED-901 | Pemetrexed (Alimta, Pemfexy) | 2/6/26 | 3/23/26 | Complete | Pemetrexed (Alimta, Pemfexy) |
| 2026-LHCC-MED-902 | Cemiplimab-rwlc (Libtayo) | 2/6/26 | 3/23/26 | Complete | Cemiplimab-rwlc (Libtayo) |
| 2026-LHCC-MED-903 | Motixafortide (Aphexda) | 2/6/26 | 3/23/26 | Complete | Motixafortide (Aphexda) |
| 2026-ACLA-MED-128 | VEGF Inhibitors | 2/6/26 | 3/23/26 | Complete | VEGF Inhibitors |
| 2026-PHARM-6 | Asthma/COPD - Immunomodulators | 2/6/26 | 3/23/26 | Complete | Asthma/COPD - Immunomodulators |
| 2026-PHARM-7 | Avtozma | 2/6/26 | 3/23/26 | Complete | Avtozma |
| 2026-PHARM-8 | Brinsupri | 2/6/26 | 3/23/26 | Complete | Brinsupri |
| 2026-PHARM-9 | Casgevy | 2/6/26 | 3/23/26 | Complete | Casgevy |
| 2026-PHARM-10 | Dawnzera | 2/6/26 | 3/23/26 | Complete | Dawnzera |
| 2026-PHARM-11 | Ekterly | 2/6/26 | 3/23/26 | Complete | Ekterly |
| 2026-PHARM-12 | Exxua | 2/6/26 | 3/23/26 | Complete | Exxua |
| 2026-PHARM-13 | Heart Disease - Hyperlipidemia, Lipotropics Other | 2/6/26 | 3/23/26 | Complete | Heart Disease - Hyperlipidemia, Lipotropics Other |
| 2026-PHARM-14 | Jascayd | 2/6/26 | 3/23/26 | Complete | Jascayd |
| 2026-PHARM-15 | Louisiana Medicaid ICD-10 Chart | 2/6/26 | 3/23/26 | Complete | Louisiana Medicaid ICD-10 Chart |
| 2026-PHARM-16 | Nypozi | 2/6/26 | 3/23/26 | Complete | Nypozi |
| 2026-PHARM-17 | Oncology Agents - Oral Other | 2/6/26 | 3/23/26 | Complete | Oncology Agents - Oral Other |
| 2026-PHARM-18 | Pain Management - Antimigraine Agents, CGRP Antagonists | 2/6/26 | 3/23/26 | Complete | Pain Management - Antimigraine Agents, CGRP Antagonists |
| 2026-PHARM-19 | Pain Management - Cytokine/CAM Antagonists | 2/6/26 | 3/23/26 | Complete | Pain Management - Cytokine/CAM Antagonists |
| 2026-PHARM-20 | Pain Management - Skeletal Muscle Relaxants | 2/6/26 | 3/23/26 | Complete | Pain Management - Skeletal Muscle Relaxants |
| 2026-PHARM-21 | POS Anzupgo | 2/6/26 | 3/23/26 | Complete | POS Anzupgo |
| 2026-PHARM-22 | POS Asthma/COPD - Immunomodulators | 2/6/26 | 3/23/26 | Complete | POS Asthma/COPD - Immunomodulators |
| 2026-PHARM-23 | POS Brinsupri | 2/6/26 | 3/23/26 | Complete | POS Brinsupri |
| 2026-PHARM-24 | POS Dermatology - Antipsoriatics, Topical | 2/6/26 | 3/23/26 | Complete | POS Dermatology - Antipsoriatics, Topical |
| 2026-PHARM-25 | POS Empaveli | 2/6/26 | 3/23/26 | Complete | POS Empaveli |
| 2026-PHARM-26 | POS Exxua | 2/6/26 | 3/23/26 | Complete | POS Exxua |
| 2026-PHARM-27 | POS Heart Disease - Hyperlipidemia, Anticoagulants | 2/6/26 | 3/23/26 | Complete | POS Heart Disease - Hyperlipidemia, Anticoagulants |
| 2026-PHARM-28 | POS Jascayd | 2/6/26 | 3/23/26 | Complete | POS Jascayd |
| 2026-PHARM-29 | POS Kirsty | 2/6/26 | 3/23/26 | Complete | POS Kirsty |
| 2026-PHARM-30 | POS Oncology - Oral Other | 2/6/26 | 3/23/26 | Complete | POS Oncology - Oral Other |
| 2026-PHARM-31 | POS Pain Management - Skeletal Muscle Relaxants | 2/6/26 | 3/23/26 | Complete | POS Pain Management - Skeletal Muscle Relaxants |
| 2026-PHARM-32 | POS Rhapsido | 2/6/26 | 3/23/26 | Complete | POS Rhapsido |
| 2026-PHARM-33 | POS Zurnai | 2/6/26 | 3/23/26 | Complete | POS Zurnai |
| 2026-PHARM-34 | Rhapsido | 2/6/26 | 3/23/26 | Complete | Rhapsido |
| 2026-PHARM-35 | Sephience | 2/6/26 | 3/23/26 | Complete | Sephience |
| 2026-PHARM-36 | Tyruko | 2/6/26 | 3/23/26 | Complete | Tyruko |
| 2026-PHARM-37 | Vyjuvek | 2/6/26 | 3/23/26 | Complete | Vyjuvek |
| 2026-PHARM-5 | Max Dose Override Buprenorphine | 2/2/26 | 3/19/26 | Complete | Max Dose Override Buprenorphine |
| 2026-PHARM-1 | Wegovy | 1/16/26 | 3/2/26 | Complete | Wegovy |
| 2026-PHARM-2 | POS Wegovy | 1/16/26 | 3/2/26 | Complete | POS Wegovy |
| 2026-PHARM-3 | Max Dose Override Buprenorphine | 1/16/26 | 3/2/26 | Complete | Max Dose Override Buprenorphine |
| 2026-PHARM-4 | POS Opiate Dependence Agents | 1/16/26 | 3/2/26 | Complete | POS Opiate Dependence Agents |
| 2026-HB-MED-647 | Rebyota (fecal microbiota, live – jslm) | 1/7/26 | 2/21/26 | Complete | Rebyota (fecal microbiota, live – jslm) |
| 2026-HB-MED-648 | Zinplava (bezlotoxumab) | 1/7/26 | 2/21/26 | Complete | Zinplava (bezlotoxumab) |
| 2026-HB-MED-649 | Xiaflex (collagenase clostridium histolyticum) | 1/7/26 | 2/21/26 | Complete | Xiaflex (collagenase clostridium histolyticum) |
| 2026-HB-MED-650 | Crysvita (burosumab-twza) | 1/7/26 | 2/21/26 | Complete | Crysvita (burosumab-twza) |
| 2026-HB-MED-651 | Veopoz (pozelimab-bbfg) | 1/7/26 | 2/21/26 | Complete | Veopoz (pozelimab-bbfg) |
| 2026-HB-MED-652 | Nexobrid (anacaulase-bcdb) | 1/7/26 | 2/21/26 | Complete | Nexobrid (anacaulase-bcdb) |
| 2026-HB-MED-653 | Gamifant (emapalumab-lzsg) | 1/7/26 | 2/21/26 | Complete | Gamifant (emapalumab-lzsg) |
| 2026-HB-MED-654 | Prostacyclin Infusion and Inhalation Therapy | 1/7/26 | 2/21/26 | Complete | Prostacyclin Infusion and Inhalation Therapy |
| 2026-HB-MED-655 | Scenesse (afamelanotide) | 1/7/26 | 2/21/26 | Complete | Scenesse (afamelanotide) |
Medicaid Managed Care Policies & Procedures Archive - Pharmacy (2026)
"Policy or procedure" shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.
Below are items previously posted for public comment:
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- Managed Care Pharmacy and Medical Drug Policies - Archive (2025)
- Managed Care Pharmacy and Medical Drug Policies - Archive (2024)
- Managed Care Pharmacy and Medical Drug Policies - Archive (2023)
- Managed Care Pharmacy and Medical Drug Policies - Archive (2022)
- Managed Care Pharmacy and Medical Drug Policies - Archive (2021)