MedicaidPrior AuthLow impact
Lymphir™ (denileukin diftitox-cxdl) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Lymphir™ (denileukin diftitox-cxdl), a cancer drug used to treat cutaneous T-cell lymphoma. Prior authorization will be required for all Lymphir prescriptions, with specific criteria including relapsed/refractory CTCL diagnosis, stage I-III disease, and prior systemic therapy.
Action Required
Before June 1, 2026: Billing team must update prior authorization systems to require preapproval for all Lymphir™ (denileukin diftitox-cxdl) prescriptions for Humana Medicaid Ohio members. Providers must document diagnosis of relapsed/refractory CTCL, disease stage I-III, and history of prior systemic therapy. Claims will be denied without proper prior authorization.