MedicaidPrior AuthMedium impact
Kyprolis® (carfilzomib) (Revised)
Humana·IN · Hematology, Oncology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has revised prior authorization requirements for Kyprolis (carfilzomib) effective December 1, 2025. The policy now includes Waldenstrom's macroglobulinemia as a covered indication and updates specific combination therapy criteria for multiple myeloma treatment.
Action Required
By December 1, 2025: Billing team must update prior authorization procedures for Kyprolis (carfilzomib) to include new Waldenstrom's macroglobulinemia indication and revised multiple myeloma combination therapy criteria. Update intake forms to capture required documentation including prior therapy history and disease progression status. Ensure providers document all required criteria before submitting authorization requests to avoid claim denials.