MedicaidPrior AuthLow impact
Sylvant® (siltuximab) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid has established a new prior authorization policy for Sylvant (siltuximab), a specialty drug used to treat multicentric Castleman's disease. The policy requires strict eligibility criteria including HIV/HHV-8 negative status and specific lab parameters, with 6-month approval periods.
Action Required
By January 1, 2026: Billing team must update prior authorization procedures for Sylvant (siltuximab) for Louisiana Medicaid patients. Ensure providers document multicentric Castleman's disease diagnosis, HIV/HHV-8 negative status, and required lab values (neutrophil count ≥1.0x10⁹/L, platelet count ≥75x10⁹/L, hemoglobin <17g/dL) before submitting PA requests. Visit www.humana.com/PAL for specific medical billing codes. Claims without proper prior authorization will be denied.