MedicaidPrior AuthMedium impact
Elitek® (rasburicase) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has established a new prior authorization policy for Elitek (rasburicase), a medication used to treat hyperuricemia in cancer patients receiving chemotherapy expected to cause tumor lysis syndrome. The policy requires specific cancer diagnoses and excludes patients with G6PD deficiency or previous hemolytic reactions.
Action Required
By October 1, 2025: Billing team must update prior authorization requirements for Elitek (rasburicase) for Humana Indiana Medicaid members. Ensure providers document: 1) diagnosis of leukemia, lymphoma, or solid tumor malignancy, 2) anti-cancer chemotherapy regimen expected to cause tumor lysis syndrome, and 3) absence of G6PD deficiency or previous hemolytic reactions to rasburicase. Update EMR templates to include these criteria. Claims without prior authorization will be denied.