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| Item Number | Policy/Procedure Date Posted Comment Period Closed Status | Date Posted Comment Period Closed Status | Comment Period Closed Status | Status | Document Links |
|---|---|---|---|---|---|
| 2025-HUMANA-MED-167 | Paclitaxel – HCPCS code J9267 9208 | 10/29/25 | 12/13/25 | Pending | Paclitaxel – HCPCS code J9267 9208 |
| 2025-HUMANA-MED-168 | carfilzomib, 1 mg – HCPCS code J9047 8997 | 10/29/25 | 12/13/25 | Pending | carfilzomib, 1 mg – HCPCS code J9047 8997 |
| 2025-HUMANA-MED-169 | ocrelizumab, 1 mg – HCPCS code J2350 9165 | 10/29/25 | 12/13/25 | Pending | ocrelizumab, 1 mg – HCPCS code J2350 9165 |
| 2025-HB-MED-642 | Bynfezia Pen, Sandostatin and Sandostatin LAR (Octreotide) / Octreotide Agents | 10/28/25 | 12/12/25 | Pending | Bynfezia Pen, Sandostatin and Sandostatin LAR (Octreotide) / Octreotide Agents |
| 2025-HB-MED-643 | Somatuline Depot (lanreotide) | 10/28/25 | 12/12/25 | Pending | Somatuline Depot (lanreotide) |
| 2025-HB-MED-646 | Bevacizumab for Non-Ophthalmologic Indications | 10/28/25 | 12/12/25 | Pending | Bevacizumab for Non-Ophthalmologic Indications |
| 2025-HB-MED-632 | Ketamine Injection (Ketalar) | 10/28/25 | 12/12/25 | Pending | Ketamine Injection (Ketalar) |
| 2025-HB-MED-635 | Darzalex (daratumumab) and Darzalex Faspro (daratumumab and hyaluronidase-fihj) | 10/28/25 | 12/12/25 | Pending | Darzalex (daratumumab) and Darzalex Faspro (daratumumab and hyaluronidase-fihj) |
| 2025-HB-MED-636 | Epkinly (epcoritamab-bysp) | 10/28/25 | 12/12/25 | Pending | Epkinly (epcoritamab-bysp) |
| 2025-HB-MED-637 | Provenge (sipuleucel-T) | 10/28/25 | 12/12/25 | Pending | Provenge (sipuleucel-T) |
| 2025-HB-MED-638 | Tevimbra (tislelizumab-jsgr) | 10/28/25 | 12/12/25 | Pending | Tevimbra (tislelizumab-jsgr) |
| 2025-HB-MED-639 | Asparagine Specific Enzymes | 10/28/25 | 12/12/25 | Pending | Asparagine Specific Enzymes |
| 2025-HB-MED-640 | Danyelza (naxitamab-gqgk) | 10/28/25 | 12/12/25 | Pending | Danyelza (naxitamab-gqgk) |
| 2025-HB-MED-641 | Pasireotide Agent: Signifor LAR (pasireotide) | 10/28/25 | 12/12/25 | Pending | Pasireotide Agent: Signifor LAR (pasireotide) |
| 2025-HB-MED-624 | Emrelis (telisotuzumab vedotin-tllv) | 10/28/25 | 12/12/25 | Pending | Emrelis (telisotuzumab vedotin-tllv) |
| 2025-HB-MED-625 | Penpulimab-kcqx | 10/28/25 | 12/12/25 | Pending | Penpulimab-kcqx |
| 2025-HB-MED-626 | Nulojix (belatacept) | 10/28/25 | 12/12/25 | Pending | Nulojix (belatacept) |
| 2025-HB-MED-627 | Drug Dosage, Frequency, and Route of Administration | 10/28/25 | 12/12/25 | Pending | Drug Dosage, Frequency, and Route of Administration |
| 2025-HB-MED-628 | Off-Label Drug and Approved Orphan Drug Use | 10/28/25 | 12/12/25 | Pending | Off-Label Drug and Approved Orphan Drug Use |
| 2025-HB-MED-630 | Zynyz (retifanlimab-dlwr) | 10/28/25 | 12/12/25 | Pending | Zynyz (retifanlimab-dlwr) |
| 2025-HB-MED-614 | Lynozyfic (linvoseltamab-gcpt) | 10/28/25 | 12/12/25 | Pending | Lynozyfic (linvoseltamab-gcpt) |
| 2025-HB-MED-615 | Zusduri (mitomycin intravesical solution) | 10/28/25 | 12/12/25 | Pending | Zusduri (mitomycin intravesical solution) |
| 2025-HB-MED-618 | Rytelo (imetelstat) | 10/28/25 | 12/12/25 | Pending | Rytelo (imetelstat) |
| 2025-HB-MED-619 | Columvi (glofitamab-gxbm) | 10/28/25 | 12/12/25 | Pending | Columvi (glofitamab-gxbm) |
| 2025-HB-MED-620 | Keytruda (pembrolizumab) | 10/28/25 | 12/12/25 | Pending | Keytruda (pembrolizumab) |
| 2025-HB-MED-621 | Levoleucovorin Agents | 10/28/25 | 12/12/25 | Pending | Levoleucovorin Agents |
| 2025-HB-MED-622 | Lymphir (denileukin difititox-cxdl) | 10/28/25 | 12/12/25 | Pending | Lymphir (denileukin difititox-cxdl) |
| 2025-HB-MED-623 | Istodax (romidepsin) | 10/28/25 | 12/12/25 | Pending | Istodax (romidepsin) |
| 2025-HB-MED-604 | Iron Agents10/28/25 | 10/28/25 | 12/12/25 | Pending | Iron Agents |
| 2025-HB-MED-605 | Rituximab Agents for Non-Oncologic Indications | 10/28/25 | 12/12/25 | Pending | Rituximab Agents for Non-Oncologic Indications |
| 2025-HB-MED-606 | Rituximab Agents for Oncologic Indications | 10/28/25 | 12/12/25 | Pending | Rituximab Agents for Oncologic Indications |
| 2025-HB-MED-607 | Beleodaq (belinostat) | 10/28/25 | 12/12/25 | Pending | Beleodaq (belinostat) |
| 2025-HB-MED-608 | Monjuvi (tafasitamab-cxix) | 10/28/25 | 12/12/25 | Pending | Monjuvi (tafasitamab-cxix) |
| 2025-HB-MED-609 | Datroway (datopotamab deruxtecan-dlnk) | 10/28/25 | 12/12/25 | Pending | Datroway (datopotamab deruxtecan-dlnk) |
| 2025-HB-MED-610 | Opdivo (nivolumab) | 10/28/25 | 12/12/25 | Pending | Opdivo (nivolumab) |
| 2025-HB-MED-611 | Opdivo Qvantig (nivolumab hyaluronidase-nvhy) | 10/28/25 | 12/12/25 | Pending | Opdivo Qvantig (nivolumab hyaluronidase-nvhy) |
| 2025-HB-MED-612 | Yervoy (ipilimumab) | 10/28/25 | 12/12/25 | Pending | Yervoy (ipilimumab) |
| 2025-HB-MED-613 | Tecelra (afamitresgene autoleucel) | 10/28/25 | 12/12/25 | Pending | Tecelra (afamitresgene autoleucel) |
| 2025-HB-MED-594 | Opdualag (nivolumab and relatlimab-rmbw) | 10/6/25 | 11/20/25 | Pending | Opdualag (nivolumab and relatlimab-rmbw) |
| 2025-HB-MED-595 | Zynlonta (loncastuximab tesirine-lpyl) | 10/6/25 | 11/20/25 | Pending | Zynlonta (loncastuximab tesirine-lpyl) |
| 2025-HB-MED-596 | Rybrevant (amivantamab-ymjw) | 10/6/25 | 11/20/25 | Pending | Rybrevant (amivantamab-ymjw) |
| 2025-HB-MED-597 | Jemperli (dostarlimab-gxly) | 10/6/25 | 11/20/25 | Pending | Jemperli (dostarlimab-gxly) |
| 2025-HB-MED-598 | Zepzelca (lurbinectedin) | 10/6/25 | 11/20/25 | Pending | Zepzelca (lurbinectedin) |
| 2025-HB-MED-599 | Ryplazim (plasminogen, human-tvmh) | 10/6/25 | 11/20/25 | Pending | Ryplazim (plasminogen, human-tvmh) |
| 2025-HB-MED-602 | Human Parathyroid Hormone | 10/6/25 | 11/20/25 | Pending | Human Parathyroid Hormone |
| 2025-LHCC-MED-866 | LInvoseltamab-gcpt (Lynozyfic) inject | 10/6/25 | 11/20/25 | Pending | LInvoseltamab-gcpt (Lynozyfic) inject |
| 2025-LHCC-MED-867 | Remestemcel-L-rknd (Ryoncil) | 10/6/25 | 11/20/25 | Pending | Remestemcel-L-rknd (Ryoncil) |
| 2025-LHCC-MED-868 | Encelto | 10/6/25 | 11/20/25 | Pending | Encelto |
| 2025-LHCC-MED-869 | Blinatumomab(Blincyto) | 10/6/25 | 11/20/25 | Pending | Blinatumomab(Blincyto) |
| 2025-LHCC-MED-870 | Eculizumab (Soliris), Eculizumab-aeeb (Bkemv), Eculizumab-aagh (Epysqli) | 10/6/25 | 11/20/25 | Pending | Eculizumab (Soliris), Eculizumab-aeeb (Bkemv), Eculizumab-aagh (Epysqli) |
| 2025-LHCC-MED-871 | Brentuximab Vedotin (Adcetris) | 10/6/25 | 11/20/25 | Pending | Brentuximab Vedotin (Adcetris) |
Managed Care Pharmacy and Medical Drug Policies
In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, 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.
The following table contains the LDH and managed care organization pharmacy and medical drug policies that are open for public comment. To provide feedback, please complete this form. Refer to the links below the table for archived postings and public comments.
Related Info
- Previously posted for public comment
- 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 and prior)
- Public comments submitted