Medicare AdvantagePrior AuthHigh impact
Asparlas™ (calaspargase pegol-mknl) (Revised)
Humana·FL, KY, SC · Oncology, Pediatrics·Medicaid
We identified it
Jul 22, 2026
Summary
This is a revised Prior Authorization policy for Asparlas™ (calaspargase pegol-mknl), a chemotherapy agent used in acute lymphoblastic leukemia treatment. The policy applies to Medicare, Medicaid programs in Florida, Kentucky, and South Carolina. Specific policy details are unavailable in the summary-only format, so the billing team must access the full policy document to identify exact authorization requirements and any changes from previous versions.
Action Required
Immediately: Billing team must access the full policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58680e to identify specific prior authorization requirements for Asparlas™ (HCPCS J9119). Determine: (1) which diagnoses require prior auth, (2) required documentation for authorization, (3) any changes from previous policy versions. Update billing system rules and EMR templates to enforce prior authorization requirements before submitting claims. Notify oncology providers and infusion center staff of new/revised requirements. Without proper prior authorization, Asparlas™ claims will be denied for affected Medicaid and Medicare members in FL, KY, and SC.