MedicaidPrior AuthMedium impact
Empliciti (elotuzumab) (New)
Humana·OH · Oncology, Hematology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented a new prior authorization policy for Empliciti (elotuzumab), a specialty medication used to treat multiple myeloma. Effective October 1, 2025, providers must obtain prior authorization before prescribing this IV medication, meeting specific criteria related to disease progression and combination therapy requirements.
Action Required
By October 1, 2025: Billing and clinical teams must implement prior authorization requirements for Empliciti (elotuzumab) prescriptions for Ohio Medicaid patients. Update EMR templates to document multiple myeloma diagnosis, prior therapy history, and planned combination regimens (with lenalidomide/dexamethasone, bortezomib/dexamethasone, or pomalidomide/dexamethasone). Train staff to verify 6-month approval durations and renewal requirements. Claims will be denied without proper prior authorization.