MedicaidPrior AuthMedium impact
Besponsa™ (inotuzumab ozogamicin) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Besponsa™ (inotuzumab ozogamicin), a specialty oncology drug for B-cell precursor acute lymphoblastic leukemia. Prior authorization will be required starting January 1, 2026, with specific clinical criteria including relapsed/refractory disease, documented CD22 blasts, and monotherapy use.
Action Required
Before January 1, 2026: Oncology providers and billing staff must implement prior authorization workflow for Besponsa (inotuzumab ozogamicin) for Louisiana Medicaid patients. Update EMR templates to capture required documentation: B-cell precursor ALL diagnosis, relapsed/refractory status, CD22 blast results from bone marrow or peripheral blood, and confirmation of monotherapy use. Train staff to submit prior auth requests through Humana's system before prescribing. Claims will be denied without prior authorization.