MedicaidPrior AuthLow impact
Sylvant® (siltuximab) (New)
Humana·IN · Oncology, Hematology, Infectious Disease·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Sylvant (siltuximab) effective January 1, 2026, for Indiana Medicaid patients with multicentric Castleman's disease. The policy requires specific diagnostic criteria and laboratory parameters to be met for initial approval and continuation of therapy.
Action Required
By January 1, 2026: Billing team must update prior authorization procedures for Sylvant (siltuximab) for Indiana Medicaid patients. Ensure providers document multicentric Castleman's disease diagnosis, HIV/HHV-8 negative status, and required laboratory values (absolute neutrophil count ≥ 1.0 x 10⁹/L, platelet count ≥ 75 x 10⁹/L, hemoglobin <17 g/dL) before prescribing. Claims without prior authorization will be denied.