MedicaidPrior AuthMedium impact
Imdelltra (tarlatamab-dlle) (New)
Humana·IN · Oncology·Medicaid
We identified it
Jul 1, 2026
Summary
Humana Medicaid–Indiana has implemented a new Prior Authorization policy for Imdelltra (tarlatamab-dlle), a recently approved oncology therapeutic. The billing team must obtain prior authorization before claims submission for Indiana Medicaid members to prevent denials.
Action Required
Immediately: Billing team must implement prior authorization requirement for Imdelltra (tarlatamab-dlle) claims for all Medicaid–Indiana members. (1) Update billing system to flag all Imdelltra claims for mandatory prior auth review before submission. (2) Notify providers and clinical staff that this drug requires pre-authorization; add to EMR alerts/templates. (3) Establish internal workflow to submit prior auth requests to Humana Medicaid–Indiana using the policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5bb. (4) Train billing and prior auth staff on Imdelltra eligibility and medical necessity criteria per the policy. Without prior authorization, claims will be denied and payment delayed.