Traditional MedicarePrior AuthMedium impact
Zynlonta™ (loncastuximab tesirine-Ipyl) (Revised)
Humana·FL, KY, SC · Oncology·Medicaid
We identified it
Jul 2, 2026
Summary
This is a revised Prior Authorization policy for Zynlonta™ (loncastuximab tesirine-Ipyl), a oncology medication. The policy applies to Medicare, Medicaid in Florida, Kentucky, and South Carolina. Billing teams must verify the specific prior authorization requirements and any changes from the previous version, as this is a 1-day-old update that may supersede older guidance.
Action Required
Immediately: Obtain the full policy document from https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5c8 to review specific prior authorization requirements and any changes from the prior version. Billing team must: (1) Update internal prior auth checklists to reflect any revised requirements for Zynlonta™ claims; (2) Notify oncology providers of updated requirements; (3) Train staff on any new documentation or submission requirements. Without proper prior authorization, Zynlonta™ claims for Medicare and Medicaid members in FL, KY, and SC will be denied. Compare this revised policy against any previous version to identify what specifically changed.