MedicaidPrior AuthMedium impact
Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) (Revised)
Humana·LA · Hematology, Oncology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has updated prior authorization requirements for stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) used in autologous stem cell transplants. The policy clarifies coverage criteria for non-Hodgkin's lymphoma and multiple myeloma patients, with specific usage duration limits.
Action Required
By January 1, 2026: Billing team must ensure prior authorization is obtained for all stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) for Louisiana Medicaid patients. Verify patient meets diagnosis criteria (NHL or MM for Mozobil/plerixafor, MM only for Aphexda), confirm combination use with G-CSF/GM-CSF, and document as part of autologous stem cell transplant protocol. Claims without proper prior authorization will be denied.