MedicaidPrior AuthMedium impact
Besponsa™ (inotuzumab ozogamicin) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has implemented a new prior authorization policy for Besponsa (inotuzumab ozogamicin), a specialty cancer medication used for B-cell precursor acute lymphoblastic leukemia. Prior authorization is required for all requests, with specific criteria including relapsed/refractory disease, documented CD22 blasts, and monotherapy use.
Action Required
By January 1, 2026: Billing team must update prior authorization tracking system to flag all Besponsa (inotuzumab ozogamicin) requests for Humana Medicaid Indiana patients. Providers must obtain prior authorization before prescribing and ensure documentation includes B-cell precursor ALL diagnosis, relapsed/refractory status, CD22 blast documentation, and confirmation of monotherapy use. Visit www.humana.com/PAL for specific medical and procedural coding information. Claims without prior authorization will be denied.