MedicaidPrior AuthLow impact
Danyelza® (naxitamab-gqgk) (Revised)
Humana·LA · Oncology, Pediatrics·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established new prior authorization requirements for Danyelza (naxitamab-gqgk), a specialty oncology drug for treating relapsed or refractory neuroblastoma in pediatric and adult patients. The policy requires specific criteria including age, diagnosis, disease location, and combination therapy requirements.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for Danyelza (naxitamab-gqgk) for Louisiana Medicaid patients. Ensure providers document: patient age 1+ years, relapsed/refractory high-risk neuroblastoma diagnosis, bone/bone marrow involvement, partial/minor response or stable disease to prior therapy, and combination use with Leukine (sargramostim). Submit prior auth requests through www.humana.com/PAL. Claims without prior authorization will be denied.