MedicaidPrior AuthLow impact
Tecvayli (teclistamab-cqyv) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established a new prior authorization policy for Tecvayli (teclistamab-cqyv), a specialized multiple myeloma treatment requiring specific patient criteria and treatment history. This drug requires REMS program participation and has significant safety monitoring requirements.
Action Required
By November 1, 2025: Billing team must update prior authorization requirements for Tecvayli (teclistamab-cqyv) for Indiana Medicaid patients. Verify patients meet all four criteria: multiple myeloma diagnosis, relapsed/refractory disease, at least four prior therapy lines including anti-CD38 monoclonal antibody, proteasome inhibitor, and immunomodulatory agent, and single-agent use. Ensure provider enrollment in TECVAYLI REMS program before prescribing. Claims will be denied without proper prior authorization.