MedicaidPrior AuthLow impact
Elzonris™ (tagraxofusp-erzs) (New)
Humana·IN · Hematology, Oncology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Elzonris (tagraxofusp-erzs) for treating blastic plasmacytoid dendritic cell neoplasm (BPDCN) under Indiana Medicaid. Requires pre-approval with specific criteria including WHO diagnosis confirmation, inpatient capability, and age 2+ years.
Action Required
Before March 1, 2026: For any BPDCN patients requiring Elzonris treatment, billing team must obtain prior authorization from Humana Indiana Medicaid confirming: WHO-classified BPDCN diagnosis, patient age 2+ years, and inpatient treatment capability for first course plus 24-hour observation. Initial approvals valid for 6 months. Update prior auth tracking system to monitor renewal requirements.