MedicaidPrior AuthMedium impact
Yartemlea (narsoplimab-wuug) (New)
Humana·OH · Hematology, Oncology, Pediatrics +2 more·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicaid (Ohio) has established a new prior authorization requirement for Yartemlea (narsoplimab-wuug), a monoclonal antibody for treating hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA) in patients aged 2 years and older. This is a brand-new coverage policy effective June 1, 2026, requiring authorization before dispensing.
Action Required
By May 15, 2026: Billing and clinical teams must implement prior authorization procedures for Yartemlea (narsoplimab-wuug) in the billing system for Ohio Medicaid members. Update authorization software to flag claims for this drug as requiring prior auth. Verify member diagnosis of TA-TMA before claim submission. Establish process for submitting prior auth requests with supporting clinical documentation of TA-TMA diagnosis to Humana. Train billing staff that approval duration will be for the plan year or as determined through clinical review. Reference www.humana.com/PAL for applicable medical and procedural coding. Claims submitted without prior authorization will be denied.