MedicaidPrior AuthMedium impact
Darzalex® (daratumumab) (New)
Humana·LA · Hematology, Oncology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Darzalex (daratumumab) for Louisiana Medicaid members with multiple myeloma, requiring specific combination therapies and treatment history documentation. Policy establishes strict criteria for newly diagnosed and relapsed/progressive disease scenarios.
Action Required
By March 1, 2026: Billing team must implement prior authorization requirements for all Darzalex (daratumumab) claims for Louisiana Medicaid members. Providers must document multiple myeloma diagnosis, treatment history, combination therapy details, and stem cell transplant eligibility status. Update EMR templates to capture required criteria including prior therapies, drug combinations, and contraindications. Claims will be denied without proper authorization.