Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
HumanaMedicaid · Prior Auth · Medicaid · IN · Oncology, Hematology, PediatricsMedium impact

Oncaspar® (pegaspargase) (Revised)

Act
by Jul 22, 2026
Effective date
Jul 22, 2026
Identified
Jul 21, 2026

Summary

Humana Indiana Medicaid revised its Oncaspar (pegaspargase) coverage policy, effective July 22, 2026. This is a prior authorization requirement for pegaspargase used in multi-agent chemotherapy regimens for acute lymphoblastic leukemia (ALL). The policy includes specific approval criteria, exclusions based on prior adverse events, and a 6-month initial and renewal authorization period.

Get alerts when payers change rules like this one

We check Humana and other payers every day and email you when a change matches your specialty and state.

Get Humana alertsPolicy Monitoring is free. No card required.

What to do

by Jul 22, 2026 · 6 steps
01Billing team must implement prior authorization requirement for Oncaspar (pegaspargase) claims for Indiana Medicaid members.
02Update billing software to flag all J9262 claims for prior auth before submission.
03Providers must verify patient meets ALL criteria (ALL diagnosis + use in multi-agent chemotherapy regimen) and does NOT have ANY exclusions (prior disease progression on asparaginase, thrombosis history, pancreatitis history, hemorrhagic events history, or bilirubin >10x ULN) before requesting authorization.
04Set up authorization tracking for 6-month initial and 6-month renewal periods.
05Claims submitted without prior authorization will be denied.
06Front-desk staff should alert oncology providers of this requirement during routine scheduling.

Codes mentioned

J9262

Original notice

Oncaspar® (pegaspargase) (Revised)
mcp.humana.com · Always check the source before changing claims.
View original ↗

Related changes

See all Humana changes →
Oncaspar® (pegaspargase) (Revised)MediumEffective Jul 22, 2026 · MedicaidOncaspar® (pegaspargase) (Revised)MediumEffective Feb 1, 2026 · MedicaidOncaspar® (pegaspargase) (Revised)MediumEffective Feb 1, 2026 · MedicaidOncaspar® (pegaspargase) (Revised)MediumEffective Jan 1, 2018 · MedicaidBrowse every Humana change in the policy list

Related policy hubs

Humana policiesIN policy changesOncologyHematologyPediatricsCode J9262

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account