MedicaidPrior AuthLow 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 established a new prior authorization policy for Empliciti (elotuzumab), a specialty cancer drug used to treat multiple myeloma. The policy requires prior authorization for all Empliciti prescriptions and sets specific clinical criteria including disease progression requirements and combination therapy specifications.
Action Required
By October 1, 2025: Providers treating multiple myeloma patients on Humana Medicaid Ohio must obtain prior authorization before prescribing Empliciti (elotuzumab). Clinical staff should verify patients meet criteria including disease progression after 1-3 prior therapies and ensure combination with required medications (lenalidomide/dexamethasone, bortezomib/dexamethasone, or pomalidomide/dexamethasone). Visit www.humana.com/PAL for specific claim codes and authorization process.