MedicaidPrior AuthMedium impact
Darzalex® (daratumumab) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Darzalex (daratumumab), effective March 1, 2026. This medication requires prior auth for multiple myeloma treatment and must meet specific combination therapy criteria or prior treatment requirements.
Action Required
Before March 1, 2026: Billing team must update prior authorization requirements for Darzalex (daratumumab) in billing system for Ohio Medicaid patients. Providers must document multiple myeloma diagnosis, specific combination therapies being used, and prior treatment history. Visit www.humana.com/PAL for medical and procedural coding information. Claims without proper prior authorization will be denied.