MedicaidPrior AuthHigh impact
Blincyto® (blinatumomab) (Revised)
Humana·IN · Oncology, Hematology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has revised its prior authorization policy for Blincyto® (blinatumomab) for Indiana Medicaid members. This is a HIGH PRIORITY update (1 day old) that may affect authorization requirements, documentation standards, or coverage criteria for this oncology medication. The billing team must obtain the complete policy details to understand specific changes from the previous version.
Action Required
IMMEDIATE: Billing team must access the complete policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584832 to determine: (1) specific prior authorization requirements for Blincyto® claims, (2) required documentation and medical necessity criteria, (3) effective date of this revision, and (4) how this revision differs from the previous policy. Update all billing staff and oncology providers on new authorization procedures before submitting Blincyto® claims to Indiana Medicaid. Failure to follow the revised prior auth requirements will result in claim denials. Determine if any workflows, templates, or system rules need modification based on the complete policy details.