Medicare AdvantagePrior AuthLow impact
Aucatzyl (obecabtagene autoleucel) (Revised)
Humana·FL · Hematology, Oncology·Medicaid
Effective date
Dec 18, 2024
We identified it
Jun 24, 2026
Summary
Humana has introduced a new prior authorization policy for Aucatzyl (obecabtagene autoleucel), a CAR-T cell therapy for relapsed or refractory B-cell precursor acute lymphoblastic leukemia in adults. The therapy requires strict eligibility criteria including documented CD19 expression, age ≥18 years, and specific disease staging, with approval limited to one dose per lifetime.
Action Required
By December 18, 2024: Billing team must update prior authorization requirements for Aucatzyl (obecabtagene autoleucel) in system for Humana Medicare and Medicaid Florida members. Providers must verify patient meets all 5 criteria (B-cell precursor ALL, relapsed/refractory disease, documented CD19 expression, age ≥18, lymphodepleting chemotherapy compatibility) and confirm absence of primary CNS lymphoma before requesting authorization. Maximum one dose per lifetime applies.