MedicaidPrior AuthMedium impact
Sarclisa (isatuximab-irfc) (Revised)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has updated their prior authorization policy for Sarclisa (isatuximab-irfc), an intravenous cancer medication for multiple myeloma treatment. The policy now includes three distinct indication categories with specific combination therapy requirements and expanded approval criteria for newly diagnosed multiple myeloma patients.
Action Required
By December 1, 2025: Billing and prior authorization teams must update Sarclisa (isatuximab-irfc) prior authorization requirements for Humana Medicaid Indiana members. Ensure documentation includes: 1) Specific multiple myeloma diagnosis type (third line, relapsed/refractory, or newly diagnosed), 2) Required combination therapies (pomalidomide+dexamethasone, carfilzomib+dexamethasone, or bortezomib+lenalidomide+dexamethasone), 3) Prior therapy history documentation, and 4) Confirmation patient has not progressed on anti-CD38 inhibitors. Update EMR templates to capture these specific criteria or prior authorizations will be denied.