Medicare AdvantagePrior AuthMedium impact
Elrexfio (elranatamab-bcmm) (Revised)
Humana·FL, KY, SC · Oncology, Hematology·Medicaid
We identified it
Jul 22, 2026
Summary
This is a revised Prior Authorization policy for Elrexfio (elranatamab-bcmm), a specialty pharmaceutical treatment. The policy applies to Medicare and Medicaid members in Florida, Kentucky, and South Carolina. Billing teams must verify prior authorization requirements before claims submission to avoid denials.
Action Required
Immediately: Billing team must obtain prior authorization for all Elrexfio (elranatamab-bcmm) claims before submission for Medicare and Medicaid members in Florida, Kentucky, and South Carolina. Coordinate with providers to identify patients requiring this drug. Update billing system alerts to flag Elrexfio prescriptions for prior auth processing. Contact Humana at the provided URL for specific prior auth requirements and submission procedures. Claims submitted without prior authorization will be denied.