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Medicare AdvantagePrior AuthMedium impact

Lynozyfic (linvoseltamab-gcpt) (New)

Humana·Oncology, Hematology·Medicare Advantage
Effective date
Sep 24, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Lynozyfic (linvoseltamab-gcpt), a new cancer drug for multiple myeloma patients. Coverage requires specific criteria including relapsed/refractory disease and at least four prior therapies.

Action Required

Action needed
By September 24, 2025: Oncology providers must obtain prior authorization from Humana Medicare Advantage before prescribing Lynozyfic (linvoseltamab-gcpt) for multiple myeloma patients. Update EMR templates to document required criteria: relapsed/refractory disease, at least four prior therapies (proteasome inhibitor, immunomodulatory agent, anti-CD38 antibody), and single-agent use. Verify patients haven't progressed on prior BCMA-directed therapy. Claims will be denied without proper authorization.