MedicaidPrior AuthMedium impact
Mylotarg® (gemtuzumab ozogamicin) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has introduced a new prior authorization policy for Mylotarg (gemtuzumab ozogamicin), an IV cancer medication used to treat acute myeloid leukemia (AML). This policy requires prior authorization approval before administering this specialized oncology drug, with specific criteria including CD33-positive disease confirmation and age requirements based on disease status.
Action Required
Before February 1, 2026: Oncology providers and billing teams must implement prior authorization procedures for Mylotarg (gemtuzumab ozogamicin) for Louisiana Medicaid patients. Verify patient meets all criteria including AML diagnosis, CD33-positive disease documentation, and appropriate age requirements before treatment. Update EMR templates to capture required documentation. Claims will be denied without proper prior authorization approval.