MedicaidPrior AuthMedium impact
Blincyto® (blinatumomab) (New)
Humana·IN · Oncology, Hematology, Pediatrics·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established a new prior authorization policy for Blincyto (blinatumomab), a specialty medication for B-cell acute lymphoblastic leukemia. This policy requires prior authorization for all Blincyto prescriptions and defines specific criteria for three different indications including relapsed/refractory ALL, MRD positive ALL, and consolidation phase treatment.
Action Required
Before October 1, 2025: Clinical staff must implement prior authorization requirements for all Blincyto (blinatumomab) prescriptions for Humana Medicaid Indiana members. Ensure documentation includes specific diagnosis criteria (Philadelphia chromosome status, remission status, MRD levels) and treatment protocol (monotherapy vs combination with tyrosine kinase inhibitors). Update EMR templates to capture required clinical information. Claims will be denied without proper prior authorization.