Asparlas™ (calaspargase pegol-mknl) (Revised)

By December 1, 2025: Billing and prior authorization teams must update internal systems to enforce this revised Asparlas prior authorization policy for Louisiana Medicaid members. Action items: (1) Configure billing system to flag all Asparlas (calaspargase pegol-mknl) pharmacy claims for prior authorization review; (2) Add age verification requirement (member must be ≤21 years) in authorization software; (3) Create authorization checklist requiring documentation of: ALL diagnosis confirmation, multi-agent chemotherapy regimen documentation, and member age verification; (4) Document exclusion screening requirements - verify member does NOT have: prior disease progression on Asparlas, history of serious thrombosis/pancreatitis/hemorrhagic events with prior asparaginase, or total bilirubin >10x upper limit of normal; (5) Set approval duration parameters to 6 months initial or as determined by clinical review; (6) Train prior authorization staff on the five mandatory clinical exclusions. Failure to obtain prior authorization will result in claim denials. Reference policy URL: https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5a1320. For medically billed requests, direct providers to www.humana.com/PAL for applicable preauthorization coding information.