Medicare AdvantagePrior AuthMedium impact
Ojjaara (momelotinib) (Revised)
Humana·Hematology, Oncology, Internal Medicine·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new prior authorization requirements for Ojjaara (momelotinib) effective January 1, 2026. This medication treats myelofibrosis and requires specific criteria including diagnosis confirmation, risk stratification, anemia documentation, and previous ruxolitinib trial or contraindication before approval.
Action Required
By January 1, 2026: Billing and clinical teams must implement prior authorization process for Ojjaara (momelotinib) prescriptions for Humana Medicare Advantage members. Providers must document primary or secondary myelofibrosis diagnosis, intermediate/high-risk classification using IPSS/DIPSS scoring, anemia with hemoglobin <10 g/dL or transfusion dependence, monotherapy use, and previous ruxolitinib trial/intolerance/contraindication. Update EMR templates to capture required criteria. Claims will be denied without proper prior authorization.