MedicaidPrior AuthMedium impact
Blincyto® (blinatumomab) (New)
Humana·OH · Oncology, Hematology, Pediatrics·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Blincyto (blinatumomab), a specialty drug for treating B-cell acute lymphoblastic leukemia. This affects billing for patients requiring this high-cost cancer medication.
Action Required
Before October 1, 2025: Billing team must implement prior authorization requirements for Blincyto (blinatumomab) prescriptions for Ohio Medicaid patients. Update pharmacy billing system to flag these requests and ensure providers document specific diagnosis criteria including Philadelphia chromosome status, disease phase, and treatment approach. Claims will be denied without proper prior authorization approval.