MedicaidPrior AuthLow impact
Lymphir™ (denileukin diftitox-cxdl) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Lymphir™ (denileukin diftitox-cxdl), a specialty drug for treating relapsed or refractory cutaneous T-cell lymphoma (CTCL). Prior authorization will be required for this IV medication starting June 1, 2026, with specific criteria including stage I-III disease and prior systemic therapy.
Action Required
By June 1, 2026: Billing team must update prior authorization workflows for Lymphir™ (denileukin diftitox-cxdl) for Louisiana Medicaid patients. Visit www.humana.com/PAL to obtain specific medical billing codes and prior authorization requirements. Ensure providers document diagnosis of relapsed/refractory CTCL, disease stage I-III, and prior systemic therapy history before prescribing. Claims will require prior authorization approval.