MedicaidPrior AuthMedium impact
Elitek® (rasburicase) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Elitek® (rasburicase) for Ohio Medicaid members, effective October 1, 2025. This medication requires prior approval for patients with cancer receiving chemotherapy expected to cause tumor lysis syndrome, with specific exclusion criteria for G6PD deficiency and previous hemolytic reactions.
Action Required
By October 1, 2025: Billing and clinical teams must implement prior authorization requirements 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. Exclude patients with G6PD deficiency or previous hemolytic reactions to rasburicase. Update billing system to flag this medication for prior auth and train staff on the two-criteria approval process.