MedicaidPrior AuthMedium impact
Elitek® (rasburicase) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Ohio Medicaid has implemented a new prior authorization policy for Elitek® (rasburicase) effective October 1, 2025. This medication is used to treat hyperuricemia in cancer patients receiving chemotherapy expected to cause tumor lysis syndrome, and now requires prior approval with specific clinical criteria including cancer diagnosis and exclusion of G6PD deficiency.
Action Required
Before October 1, 2025: Billing and clinical teams must establish prior authorization workflow for Elitek® (rasburicase) for Ohio Medicaid patients. Verify patients have leukemia, lymphoma, or solid tumor malignancy and are receiving anti-cancer chemotherapy expected to cause tumor lysis syndrome. Screen for G6PD deficiency and prior hemolytic reactions before requesting authorization. Claims will be denied without proper prior approval.