MedicaidPrior AuthMedium impact
Oncaspar® (pegaspargase) (New)
Humana·OH · Oncology, Hematology, Pediatrics·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Oncaspar (pegaspargase) used in treating acute lymphoblastic leukemia (ALL). This cancer medication now requires prior approval with specific clinical criteria and exclusions before coverage is approved.
Action Required
Before February 1, 2026: Billing and clinical staff must implement prior authorization requirements for all Oncaspar (pegaspargase) prescriptions for Medicaid Ohio patients. Providers must verify patients meet criteria (ALL diagnosis, multi-agent chemotherapy use) and document absence of exclusions (disease progression, history of thrombosis/pancreatitis/hemorrhage with prior asparaginase, elevated bilirubin >10x normal). Submit prior auth requests through Humana's system with 6-month approval duration. Claims will be denied without prior authorization.