MedicaidPrior AuthMedium impact
Erwinase® (asparaginase Erwinia chrysanthemi) (Revised)
Humana·LA · Oncology, Hematology, Pharmacy·Medicaid
Effective date
Nov 1, 2025
We identified it
Aug 12, 2026
Summary
Humana Louisiana Medicaid has updated its prior authorization policy for Erwinase® (asparaginase Erwinia chrysanthemi), effective November 1, 2025, with a revision dated July 22, 2026. Coverage now requires documented Grade 2-4 hypersensitivity to prior pegaspargase treatment, use as part of multi-agent chemotherapy for ALL, and excludes patients with serious pancreatitis, thrombosis, hemorrhage, or disease progression on prior asparaginase therapy. Prior authorization is required with initial and renewal approvals valid for 6 months.
Action Required
By November 1, 2025: Billing team must implement prior authorization requirement for Erwinase® (asparaginase Erwinia chrysanthemi) claims for Humana Louisiana Medicaid members. Before submitting claims, verify: (1) member has ALL diagnosis, (2) member has documented Grade 2-4 hypersensitivity to prior pegaspargase treatment per CTCAE criteria, (3) Erwinase is part of multi-agent chemotherapy regimen, and (4) member does not meet any exclusion criteria (serious pancreatitis, thrombosis, hemorrhage, or disease progression history with asparaginase). Submit prior authorization requests through Humana's PAL system (www.humana.com/PAL) before dispensing. Set internal reminder system for 6-month renewal prior authorizations. Claims submitted without required prior authorization will be denied. Oncology/hematology providers must include hypersensitivity documentation (CTCAE grading) and treatment history in all requests.