Medicare AdvantagePrior AuthHigh impact
Monjuvi® (tafasitamab-cxix) (Revised)
Humana·FL, KY, SC · Oncology, Hematology·Medicaid
We identified it
Jul 22, 2026
Summary
This is a revised Prior Authorization policy for Monjuvi® (tafasitamab-cxix), a monoclonal antibody used in oncology. The policy applies to Medicare and three state Medicaid programs (Florida, Kentucky, South Carolina) and establishes new or updated prior authorization requirements for this drug. However, specific policy details are not provided in this summary-only source.
Action Required
Immediately: Billing team must obtain the complete policy document from Humana at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a586802 to identify specific prior authorization requirements for Monjuvi® (J9349). Update billing software and claims submission workflows to reflect any new or changed PA requirements for Medicare and Medicaid members in FL, KY, and SC. Train providers and billing staff on updated documentation and clinical criteria requirements. All claims for Monjuvi® must include required prior authorization before submission to avoid denials.