MedicaidPrior AuthMedium impact
Monjuvi® (tafasitamab-cxix) (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 Monjuvi (tafasitamab-cxix), an IV cancer medication used to treat diffuse large B-cell lymphoma and follicular lymphoma. Prior authorization is now required with specific clinical criteria including relapsed/refractory disease and ineligibility for stem cell transplant.
Action Required
By October 1, 2025: Billing and clinical staff must implement prior authorization requirements for Monjuvi (tafasitamab-cxix) for Ohio Medicaid patients. Update prior authorization request forms to include required clinical criteria: diagnosis of DLBCL or follicular lymphoma, relapsed/refractory disease status, stem cell transplant eligibility assessment, and combination therapy protocols. Train staff on exclusion criteria including disease progression on anti-CD-19 therapy. Claims without proper prior authorization will be denied.