MedicaidPrior AuthHigh impact
Bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta) (New)
Humana·IN · Hematology, Oncology·Medicaid
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has implemented a new prior authorization policy for all bendamustine cancer treatment products (Treanda, Bendeka, Belrapzo, Vivimusta) effective May 1, 2026. This policy requires prior authorization for treatment of chronic lymphocytic leukemia, multiple myeloma, Hodgkin lymphoma, Non-Hodgkin's lymphoma, and Waldenström's macroglobulinemia with specific clinical criteria that must be met for approval.
Action Required
Before May 1, 2026: Billing and clinical teams must implement prior authorization requirements for all bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta) for Indiana Medicaid patients. Update billing system to flag these medications for prior auth. Providers must document specific diagnosis codes and ensure patients meet clinical criteria including appropriate disease stage and no prior disease progression on bendamustine regimens. Failure to obtain prior authorization will result in claim denials.