MedicaidPrior AuthMedium impact
Monjuvi® (tafasitamab-cxix) (New)
Humana·IN · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana Medicaid-Indiana has implemented a new Prior Authorization policy for Monjuvi® (tafasitamab-cxix), a monoclonal antibody used in oncology. Billing teams must obtain prior authorization before administering this drug to Indiana Medicaid members to avoid claim denials.
Action Required
Immediately: Billing and clinical staff must implement prior authorization process for Monjuvi® (tafasitamab-cxix / HCPCS J9349) for all Humana Medicaid-Indiana members. Review the complete policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584835 to identify specific authorization requirements, documentation needed, and submission procedures. Update billing software and EMR templates to flag J9349 claims for prior auth verification before submission. Train oncology providers and infusion center staff on new authorization workflows. Claims submitted without documented prior authorization approval will be denied.