MedicaidPrior AuthMedium impact
Talvey (talquetamab) (Revised)
Humana·LA · Oncology·Medicaid
We identified it
Jul 23, 2026
Summary
This is a revised Prior Authorization policy for Talvey (talquetamab) affecting Louisiana Medicaid members. The billing team must implement updated prior authorization requirements for this medication. Specific clinical criteria and effective dates cannot be confirmed from the summary-only source provided.
Action Required
Immediately: Billing and prior authorization teams must obtain the full policy document from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58481a) to identify specific HCPCS codes, clinical criteria, and effective dates for Talvey (talquetamab). Update billing system and prior authorization workflows to reflect revised requirements for Louisiana Medicaid members. Do not process Talvey claims without confirming current prior authorization requirements, as claims submitted under outdated criteria will be denied. Flag this policy as superseding any prior Talvey guidance issued before the 1-day-old date.