MedicaidPrior AuthMedium impact
Talvey (talquetamab) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has implemented a new prior authorization policy for Talvey (talquetamab), a specialty cancer medication for multiple myeloma patients. This drug requires prior auth verification that patients have relapsed/refractory disease and have tried at least four prior therapies including specific drug classes.
Action Required
Before November 1, 2025: Billing team must establish prior authorization workflow for Talvey (talquetamab) subcutaneous solution for Indiana Medicaid patients. Providers treating multiple myeloma must document that patients meet all four criteria: diagnosis of multiple myeloma, relapsed/refractory disease, at least four prior therapies including anti-CD38 monoclonal antibody, proteasome inhibitor, and immunomodulatory agent, and single-agent use. Claims without prior authorization will be denied.