MedicaidPrior AuthMedium impact
Kimmtrak (tebentafusp-tebn) (Revised)
Humana·LA · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana Medicaid-Louisiana has issued a revised Prior Authorization policy for Kimmtrak (tebentafusp-tebn), a bispecific protein immunotherapy. This update requires prior authorization before billing this drug for Louisiana Medicaid members. Billing teams must implement authorization verification workflows to prevent claim denials.
Action Required
Immediately: Billing team must implement prior authorization requirement for Kimmtrak (HCPCS code J9119) for all Louisiana Medicaid members. Update billing system to flag claims for J9119 and require documentation of prior auth approval before submission. Coordinate with providers and infusion centers to obtain Humana prior authorization before drug administration. Contact Humana at the URL provided (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58481c) to access full policy details and authorization submission process. Without prior authorization, claims for J9119 will be denied and members may be held liable.