MedicaidPrior AuthMedium impact
Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) (New)
Humana·OH · Hematology, Oncology·Medicaid
We identified it
Jul 2, 2026
Summary
Humana has issued a new Prior Authorization policy for stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) affecting Ohio Medicaid members. Billing teams must implement prior authorization requirements before dispensing or billing these medications to avoid claim denials.
Action Required
Immediately: Billing and pharmacy teams must implement prior authorization workflow for stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor) for all Ohio Medicaid claims. Update billing system to flag these medications for prior auth requirement before claim submission. Notify prescribers and pharmacy staff of new requirement. Contact Humana at the provided source URL to access full policy details including specific approval criteria and submission process. Claims submitted without prior authorization will be denied. Verify effective date and any transition period directly with Humana as this is a summary-only notification.