MedicaidPrior AuthLow impact
Kimmtrak (tebentafusp-tebn) (New)
Humana·IN · Oncology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established a new prior authorization policy for Kimmtrak (tebentafusp-tebn), a specialty drug for treating metastatic uveal melanoma. Prior authorization will be required starting December 1, 2025, with specific criteria including HLA-A*02:01-positive disease confirmation and use as monotherapy.
Action Required
By December 1, 2025: Oncology providers treating uveal melanoma patients must obtain prior authorization before prescribing Kimmtrak (tebentafusp-tebn) for Humana Medicaid Indiana members. Ensure patient has documented HLA-A*02:01-positive disease by assay results and meets unresectable or metastatic uveal melanoma diagnosis criteria. Visit www.humana.com/PAL for specific prior authorization procedures and medical coding information.