MedicaidPrior AuthMedium impact
Yartemlea (narsoplimab-wuug) (New)
Humana·LA · Hematology, Oncology, Transplant Surgery +1 more·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 25, 2026
Summary
Humana Louisiana Medicaid has established a new prior authorization policy for Yartemlea (narsoplimab-wuug), a monoclonal antibody indicated for treating hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA) in patients aged 2 years and older. Effective June 1, 2026, all claims for this intravenous medication require prior authorization based on a single approval criterion: confirmed diagnosis of TA-TMA. Approval duration is for the plan year or as determined through clinical review.
Action Required
By June 1, 2026: Billing team must implement prior authorization requirements for all Yartemlea (narsoplimab-wuug) claims submitted to Humana Louisiana Medicaid. (1) Update billing system to flag Yartemlea claims for mandatory prior authorization before submission. (2) Create a prior auth checklist requiring documentation of TA-TMA diagnosis (ICD-10 code required). (3) Train billing and clinical staff that approval duration extends through the plan year or until clinical review determines otherwise. (4) Reference www.humana.com/PAL for current medical claim coding requirements. (5) Establish internal tracking for initial and renewal authorizations. Claims submitted without prior authorization will be denied. Coordinate with providers to ensure TA-TMA diagnosis is clearly documented on all requests.