MedicaidPrior AuthLow impact
Anktiva (nogapendekin alfa inbakicept-pmln) (New)
Humana·OH · Oncology, Urology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Anktiva (nogapendekin alfa inbakicept-pmln), a new cancer drug for treating BCG-unresponsive non-muscle invasive bladder cancer. This intravesical solution requires prior authorization with specific criteria including age 18+, documented carcinoma in situ, BCG-unresponsive disease, and must be used concurrently with BCG therapy.
Action Required
Before June 1, 2026: Billing team must update prior authorization requirements for Anktiva (nogapendekin alfa inbakicept-pmln) in billing system for Ohio Medicaid patients. Providers treating bladder cancer patients must verify all five criteria are met before prescribing and obtain prior authorization. Visit www.humana.com/PAL for specific medical and procedural coding information. Claims will be denied without proper prior authorization.