MedicaidPrior AuthMedium impact
Blincyto® (blinatumomab) (New)
Humana·LA · Hematology, Oncology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Blincyto (blinatumomab) for Louisiana Medicaid patients with B-cell acute lymphoblastic leukemia. This specialty cancer medication requires prior auth approval with specific diagnostic and treatment criteria that must be met before coverage is approved.
Action Required
Before October 1, 2025: For Louisiana Medicaid patients receiving Blincyto (blinatumomab) for B-cell ALL, providers must obtain prior authorization by documenting patient meets specific diagnostic criteria including Philadelphia chromosome status, disease stage (relapsed/refractory, MRD positive, or consolidation phase), and treatment approach (monotherapy or combination therapy). Update prior authorization workflow to include these requirements. Claims will be denied without proper prior authorization.