MedicaidPrior AuthHigh impact
Blincyto® (blinatumomab) (Revised)
Humana·OH · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has revised its Prior Authorization policy for Blincyto® (blinatumomab) for Ohio Medicaid members. This is a drug-specific policy update that likely affects coverage requirements, authorization procedures, or clinical criteria for this cancer treatment. The billing team must obtain current policy details to understand specific changes from the previous version.
Action Required
IMMEDIATELY: Billing team must access the full policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58482e to retrieve: (1) specific effective date of this revision, (2) prior authorization requirements and process for Blincyto® claims, (3) any changes from the previous policy version, and (4) clinical criteria or documentation requirements. Update internal compliance tracking and staff training materials with new requirements before submitting any Blincyto® claims for Ohio Medicaid members. Contact Humana directly if the summary-only format does not provide sufficient detail for implementation. Failure to follow updated prior authorization procedures will result in claim denials.