MedicaidPrior AuthMedium impact
Oncaspar® (pegaspargase) (New)
Humana·IN · Oncology, Hematology, Pediatrics·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established a new prior authorization policy for Oncaspar (pegaspargase), a chemotherapy drug used to treat acute lymphoblastic leukemia (ALL). The policy requires prior approval based on specific clinical criteria and excludes patients with certain medical histories.
Action Required
Before February 1, 2026: Billing team must update prior authorization tracking system to flag all Oncaspar (pegaspargase) orders for Indiana Medicaid patients. Providers treating ALL patients must obtain prior auth by documenting: 1) ALL diagnosis, 2) use as part of multi-agent chemotherapy regimen, and 3) absence of exclusionary conditions (disease progression, prior thrombosis/pancreatitis/hemorrhage with asparaginase, or severely elevated bilirubin). Visit www.humana.com/PAL for medical coding requirements. Claims will be denied without proper prior authorization.