MedicaidPrior AuthLow impact
Elzonris™ (tagraxofusp-erzs) (New)
Humana·LA · Hematology, Oncology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Elzonris (tagraxofusp-erzs), a specialty drug for treating blastic plasmacytoid dendritic cell neoplasm (BPDCN). This affects billing for this rare cancer treatment requiring inpatient administration and specific age/diagnosis criteria.
Action Required
By March 1, 2026: Billing team must implement prior authorization requirements for Elzonris (tagraxofusp-erzs) for Louisiana Medicaid patients. Update system to verify patient meets criteria: BPDCN diagnosis per WHO classification, age 2+ years, and inpatient capability for first course plus 24-hour observation. Obtain prior auth before treatment or claims will be denied.