Traditional MedicarePrior AuthMedium impact
Trisenox® (arsenic trioxide) (Revised)
Humana·FL, KY, SC, VA · Oncology, Hematology·Medicaid
Effective date
Jan 28, 2026
We identified it
Jun 25, 2026
Summary
Humana revised its Trisenox (arsenic trioxide) prior authorization policy effective January 28, 2026. The policy covers intravenous arsenic trioxide for acute promyelocytic leukemia (APL) requiring prior authorization for induction therapy, consolidation therapy, or relapsed disease across Medicare and four state Medicaid programs. The revision date of January 28, 2026 indicates recent updates to clinical guidance, warnings, or approval criteria that billing teams must implement immediately.
Action Required
By January 28, 2026: Billing team must ensure all Trisenox (arsenic trioxide) intravenous solution claims require prior authorization before submission. Verify that patient meets BOTH criteria: (1) confirmed diagnosis of acute promyelocytic leukemia (APL), and (2) medication is for induction therapy, consolidation therapy, or relapsed disease. Update billing system work queue alerts to flag all Trisenox claims for PA verification. Coordinate with oncology providers to ensure PA requests include APL diagnosis confirmation and treatment phase documentation. Failure to obtain prior authorization will result in claim denials. NOTE: This policy applies only to Medicare, Medicaid-Florida, Medicaid-Kentucky, Medicaid-South Carolina, and Medicaid-Virginia members—verify plan type before applying PA requirement.