MedicaidPrior AuthMedium impact
Elitek® (rasburicase) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has implemented a new prior authorization policy for Elitek (rasburicase) for treating hyperuricemia in cancer patients receiving chemotherapy. Prior authorization is required for all Elitek claims and must demonstrate specific cancer diagnosis and expected tumor lysis syndrome.
Action Required
By October 1, 2025: Billing team must implement prior authorization requirements for all Elitek (rasburicase) claims for Humana Medicaid Indiana members. Providers must document: 1) Cancer diagnosis (leukemia, lymphoma, or solid tumor), 2) Anti-cancer chemotherapy regimen expected to cause tumor lysis syndrome, 3) Absence of G6PD deficiency, and 4) No history of hemolytic reactions to rasburicase. Update billing system to flag these requirements and ensure prior auth is obtained before administration to avoid claim denials.