MedicaidPrior AuthMedium impact
Erwinase® (asparaginase Erwinia chrysanthemi) (New)
Humana·OH · Oncology, Hematology, Pediatrics·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented a new prior authorization policy for Erwinase (asparaginase Erwinia chrysanthemi), a specialty oncology medication used for acute lymphoblastic leukemia patients who have experienced hypersensitivity to standard treatments. Prior authorization is required with specific clinical criteria including documented Grade 2-4 hypersensitivity to Oncaspar and use as part of multi-agent chemotherapy.
Action Required
By November 1, 2025: Billing and clinical teams must implement prior authorization requirements for Erwinase (asparaginase Erwinia chrysanthemi) for Ohio Medicaid patients. Ensure documentation includes ALL diagnosis, Grade 2-4 hypersensitivity history to Oncaspar, multi-agent chemotherapy regimen details, and absence of exclusion criteria (pancreatitis, thrombosis, hemorrhage, or disease progression with prior asparaginase therapy). Update EMR templates and prior auth workflows to capture required clinical criteria for 6-month approval periods.