MedicaidPrior AuthLow impact
Poteligeo® (mogamulizumab-kpkc) (New)
Humana·OH · Oncology, Hematology, Dermatology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Poteligeo (mogamulizumab-kpkc), an IV cancer drug used to treat mycosis fungoides or Sézary syndrome. This requires prior approval for patients with relapsed/refractory disease using it as sole systemic therapy.
Action Required
Before March 1, 2026: Billing team must update prior authorization system to flag Poteligeo (mogamulizumab-kpkc) for Medicaid Ohio patients. Providers treating mycosis fungoides or Sézary syndrome must obtain prior auth demonstrating relapsed/refractory disease and sole systemic therapy use. Claims will be denied without prior authorization.