MedicaidPrior AuthLow impact
Defitelio® (defibrotide sodium) (Revised)
Humana·IN · Oncology, Hematology, Transplant Surgery·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established prior authorization requirements for Defitelio (defibrotide sodium), a medication used to treat veno-occlusive disease following stem cell transplants. The policy requires patients to have VOD/SOS with renal or pulmonary dysfunction and excludes concurrent use with anticoagulants.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows for Defitelio (defibrotide sodium) for Humana Medicaid Indiana members. Verify patients have VOD/SOS diagnosis with renal or pulmonary dysfunction following stem cell transplant and confirm no concurrent anticoagulant use. Initial approvals are for 60 days. Claims will be denied without proper prior authorization.