MedicaidPrior AuthMedium impact
Tecvayli (teclistamab-cqyv) (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 Tecvayli (teclistamab-cqyv), a specialty drug for relapsed/refractory multiple myeloma patients. Prior authorization is required and must demonstrate the patient has failed at least four prior therapies including specific drug classes.
Action Required
Before November 1, 2025: Billing team must implement prior authorization requirements for Tecvayli (teclistamab-cqyv) prescriptions for Ohio Medicaid patients. Providers must document patient diagnosis of multiple myeloma, relapsed/refractory status, and failure of at least four prior therapies including anti-CD38 monoclonal antibody, proteasome inhibitor, and immunomodulatory agent. Claims will be denied without proper prior authorization approval.