MedicaidPrior AuthMedium impact
Monjuvi® (tafasitamab-cxix) (New)
Humana·OH · Oncology, Hematology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has issued a new Prior Authorization policy for Monjuvi® (tafasitamab-cxix), a monoclonal antibody treatment, effective for Ohio Medicaid members. This policy establishes prior authorization requirements that must be obtained before administering this medication to ensure coverage and avoid claim denials.
Action Required
Immediately: Billing and clinical teams must implement prior authorization requirements for Monjuvi® (tafasitamab-cxix, CPT J9349) for all Ohio Medicaid members. Before submitting claims, obtain prior authorization from Humana using the source URL provided (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584833). Update billing system workflows and provider encounter documentation to flag this drug as requiring pre-treatment authorization. Train oncology/hematology staff on the new authorization process. Claims submitted without prior authorization will be denied for Ohio Medicaid beneficiaries.