Medium impact
Empliciti (elotuzumab) (Revised)
Humana·Effective Feb 25, 2026
Humana revised its Empliciti (elotuzumab) prior authorization policy effective February 25, 2026, clarifying coverage criteria for multiple myeloma treatment across Medicare, Medicaid-Florida, Medicaid-Kentucky, and Medicaid-South Carolina. The policy requires prior authorization and specifies that coverage is limited to patients with disease progression after 1-3 prior lines of therapy (with lenalidomide/dexamethasone or bortezomib/dexamethasone combinations) or at least 2 prior therapies including lenalidomide and proteasome inhibitors (with pomalidomide/dexamethasone). Billing teams must ensure all Empliciti requests meet these updated clinical criteria before claim submission.