MedicaidPrior AuthMedium impact
Asparlas™ (calaspargase pegol-mknl) (Revised)
Humana·IN · Oncology, Pediatrics, Hematology·Medicaid
Effective date
Dec 1, 2025
We identified it
Aug 12, 2026
Summary
Humana Medicaid Indiana has issued a revised prior authorization policy for Asparlas (calaspargase pegol-mknl) effective December 1, 2025, with a revision date of July 22, 2026. The policy requires prior authorization for this intravenous chemotherapy drug used to treat acute lymphoblastic leukemia (ALL) in patients age 21 and younger as part of multi-agent chemotherapy regimens. The policy includes specific approval criteria and five clinical exclusions that may render patients ineligible for coverage.
Action Required
By December 1, 2025: Billing team must implement prior authorization requirements for all Asparlas (calaspargase pegol-mknl) claims submitted to Humana Medicaid Indiana. Before submitting claims, verify that: (1) patient has documented ALL diagnosis, (2) drug is being used as part of multi-agent chemotherapy regimen, (3) patient age is ≤21 years, and (4) patient does NOT have any exclusion conditions (prior disease progression on Asparlas, history of serious thrombosis, pancreatitis, hemorrhagic events with prior asparaginase therapy, or total bilirubin >10x upper limit of normal). Update claim submission workflows to obtain prior authorization before drug administration. Contact Humana PAL at www.humana.com/PAL for medical billing request procedures and applicable preauthorization codes. Claims submitted without prior authorization will be denied.