MedicaidPrior AuthMedium impact
Kyprolis® (carfilzomib) (Revised)
Humana·LA · Hematology, Oncology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has revised prior authorization criteria for Kyprolis (carfilzomib), adding new coverage for Waldenstrom's macroglobulinemia and expanding combination therapy options for multiple myeloma patients. The policy now includes specific requirements for different treatment combinations and excludes patients who previously progressed on Kyprolis.
Action Required
By December 1, 2025: Update prior authorization protocols for Kyprolis (carfilzomib) to include new Waldenstrom's macroglobulinemia coverage criteria and revised multiple myeloma combination therapy requirements. Ensure documentation includes specific diagnosis codes, prior therapy history, and combination drug regimens. Claims without proper prior authorization will be denied for Louisiana Medicaid patients.