MedicaidPrior AuthMedium impact
Elrexfio (elranatamab-bcmm) (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 Elrexfio (elranatamab-bcmm), a specialty oncology drug for treating relapsed/refractory multiple myeloma. Prior authorization is required for patients who have received at least four prior lines of therapy and must use the drug as a single agent.
Action Required
Before January 1, 2026: Billing team must update prior authorization requirements for Elrexfio (elranatamab-bcmm) in billing system for Louisiana Medicaid patients. Providers must verify patients meet all four criteria including multiple myeloma diagnosis, relapsed/refractory disease, at least four prior therapy lines, and single agent use. Claims without prior authorization will be denied.