MedicaidPrior AuthMedium impact
Mylotarg® (gemtuzumab ozogamicin) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Mylotarg (gemtuzumab ozogamicin), a cancer medication used to treat acute myeloid leukemia. Prior authorization is now required for all Mylotarg prescriptions with specific criteria for CD33-positive AML patients.
Action Required
By February 1, 2026: Billing team must ensure all Mylotarg (gemtuzumab ozogamicin) prescriptions for Ohio Medicaid patients include prior authorization approval before dispensing. Providers must document CD33-positive acute myeloid leukemia diagnosis and meet age-specific criteria (1 month+ for newly diagnosed, 2 years+ for relapsed/refractory). Claims without prior authorization will be denied.