MedicaidPrior AuthMedium impact
Talvey (talquetamab) (Revised)
Humana·IN · Oncology, Hematology·Medicaid
We identified it
Jul 23, 2026
Summary
Humana has revised its Prior Authorization policy for Talvey (talquetamab) for Indiana Medicaid members. This is a recent update (1 day old) affecting coverage and authorization requirements for this medication. The billing team must obtain the full policy details to implement necessary changes to authorization workflows.
Action Required
Immediately: Billing team must access the complete policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584818 to determine specific prior authorization requirements for Talvey (talquetamab) claims. Update billing system and clinical staff workflows to reflect any new authorization triggers, documentation requirements, or approval processes. Flag all Talvey claims from Indiana Medicaid members for manual review until new procedures are implemented. Communicate revised requirements to providers and prior authorization team. Failure to comply with new requirements will result in claim denials for Indiana Medicaid beneficiaries.