MedicaidPrior AuthMedium impact
Talvey (talquetamab) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid (Ohio) has established a new prior authorization policy for Talvey (talquetamab), a specialty oncology drug for multiple myeloma treatment. Patients must meet strict criteria including relapsed/refractory disease and at least four prior therapies before approval.
Action Required
By November 1, 2025: Billing and clinical teams must implement prior authorization requirements for Talvey (talquetamab) for Ohio Medicaid patients. Verify patients meet all four criteria: multiple myeloma diagnosis, relapsed/refractory disease, at least four prior therapies (including anti-CD38 monoclonal antibody, proteasome inhibitor, and immunomodulatory agent), and single-agent use. Submit prior auth requests through www.humana.com/PAL. Claims will be denied without proper authorization.