MedicaidPrior AuthMedium impact
Bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established new prior authorization requirements for all bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta) used to treat various blood cancers and lymphomas. Prior authorization will be required for chronic lymphocytic leukemia, multiple myeloma, Hodgkin lymphoma, non-Hodgkin's lymphoma, and Waldenström's macroglobulinemia starting May 1, 2026.
Action Required
Before May 1, 2026: Billing team and oncology providers must establish prior authorization workflow for all bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta) for Humana Medicaid Ohio patients. Update billing system to flag these medications for prior auth. Providers must document specific diagnosis criteria and ensure patients don't have exclusions like disease progression on bendamustine. Claims will be denied without proper prior authorization.