MedicaidPrior AuthMedium impact
Provider Letter 2021-04: Prior Authorization of Medications Used to Treat Multiple Myeloma
Oklahoma SoonerCare·OK · Oncology, Hematology·Prior Authorization
Effective date
Jun 7, 2021
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid (SoonerCare) will require prior authorization for five multiple myeloma medications starting June 7, 2021: Darzalex, Empliciti, Ninlaro, Sarclisa, and Xpovio. Current patients will be automatically approved for continuation, but new therapy started after April 15, 2021 requires manual prior authorization to avoid treatment disruption.
Action Required
Before June 7, 2021: Billing team must submit prior authorization requests for SoonerCare members who started Darzalex, Empliciti, Ninlaro, Sarclisa, or Xpovio after April 15, 2021. Use drug-specific forms from OHCA website (except Hemady uses PHARM-04 form). Fax requests to pharmacy prior authorization unit, not medical authorization unit. Include dates of previous doses on forms. Contact 800-522-0114 option 4 with questions.