MedicaidPrior AuthMedium impact
Imdelltra (tarlatamab-dlle) (New)
Humana·OH · Oncology, Hematology·Medicaid
We identified it
Jul 1, 2026
Summary
Humana Ohio Medicaid has implemented a new prior authorization policy for Imdelltra (tarlatamab-dlle), a novel therapeutic agent. Billing teams must obtain prior authorization before claims submission for Ohio Medicaid members to avoid denials. The policy is effective immediately as of the 1-day-old posting date.
Action Required
Immediately: Billing team must implement prior authorization requirement for Imdelltra (tarlatamab-dlle) claims submitted for Humana Ohio Medicaid members. Update billing system workflow to flag all Imdelltra claims for prior auth processing before submission. Contact Humana Ohio through the provided DCTM link (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5b9) to establish prior authorization submission process and obtain required clinical documentation templates. Notify prescribing providers that Imdelltra now requires pre-authorization. Failure to obtain prior authorization will result in claim denials for Ohio Medicaid beneficiaries.