Medicare AdvantagePrior AuthLow impact
Pedmark® (sodium thiosulfate injection) (Revised)
Humana·FL, KY, SC · Oncology, Pediatrics·Medicaid
Effective date
Aug 27, 2025
We identified it
Jun 24, 2026
Summary
Humana has revised their prior authorization policy for Pedmark (sodium thiosulfate injection) used to prevent cisplatin-induced hearing loss in pediatric cancer patients. The policy requires prior auth for patients 1 month to 18 years old with localized solid tumors receiving cisplatin chemotherapy.
Action Required
By August 27, 2025: Billing team must ensure prior authorization is obtained for all Pedmark (sodium thiosulfate injection) prescriptions for pediatric patients (1 month to 18 years) with localized solid tumors receiving cisplatin therapy. Verify patient meets all three criteria: correct age range, localized non-metastatic solid tumor, and cisplatin-based therapy. Claims will be denied without proper prior authorization.