MedicaidPrior AuthMedium impact
Jemperli (dostarlimab-gxly) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has introduced a new prior authorization policy for Jemperli (dostarlimab-gxly), an IV cancer treatment for endometrial cancer and solid tumors with mismatch repair deficiency. Prior authorization will be required for all three approved indications with specific clinical criteria and exclusions that must be met.
Action Required
By November 1, 2025: Billing and clinical teams must implement prior authorization requirements for Jemperli (dostarlimab-gxly) for Humana Medicaid Ohio patients. Update billing system to flag this medication for prior auth. Providers must document specific clinical criteria including cancer diagnosis, prior treatments, and combination therapy details. Visit www.humana.com/PAL for medical and procedural coding information. Claims will be denied without proper prior authorization.