MedicaidPrior AuthMedium impact
Lymphir™ (denileukin diftitox-cxdl) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established a new prior authorization policy for Lymphir™ (denileukin diftitox-cxdl), an IV cancer treatment for cutaneous T-cell lymphoma. Approval requires documentation of relapsed/refractory CTCL stages I-III and at least one prior systemic therapy.
Action Required
Before June 1, 2026: Billing team must update prior authorization requirements for Lymphir™ (denileukin diftitox-cxdl) in billing system for Humana Medicaid Indiana members. Providers must document: 1) relapsed or refractory CTCL diagnosis, 2) disease stage I-III, and 3) history of at least one prior systemic therapy. Visit www.humana.com/PAL for specific medical billing codes. Claims without prior authorization will be denied.