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HumanaMedicaid · Prior Auth · Medicaid · LA · Oncology, Pediatrics, HematologyLow impact

Erwinase® (asparaginase Erwinia chrysanthemi) (Revised)

Effective date
Nov 1, 2025
Identified
Oct 6, 2026

Summary

This is a historical Medicaid pharmacy prior authorization policy for Erwinase (asparaginase Erwinia chrysanthemi), a specialized leukemia treatment, newly discovered on 2026-10-06 but originally effective 2025-11-01 and last revised 2026-07-22. The policy establishes coverage criteria requiring documented Grade 2-4 hypersensitivity to prior pegaspargase therapy, use as part of multi-agent chemotherapy, and excludes members with history of serious pancreatitis, thrombosis, hemorrhage, or disease progression on asparaginase therapy. Verify current applicability with Humana before implementing.

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What to do

Action · 4 steps
01Already effective 2025-11-01 (historical material newly discovered 2026-10-06): Billing team should verify whether this Louisiana Medicaid Erwinase prior authorization policy remains current by consulting Humana's online Medical and Pharmacy Coverage Policies portal at www.humana.com/PAL and confirming the policy has not been superseded.
02If this policy is still active, ensure claims for Erwinase (asparaginase Erwinia chrysanthemi) for Louisiana Medicaid members include prior authorization documentation demonstrating: (1) ALL diagnosis, (2) documented Grade 2-4 hypersensitivity to prior Oncaspar therapy per CTCAE criteria, (3) use within multi-agent chemotherapy regimen, and (4) absence of exclusionary conditions.
03Initial approval duration is 6 months or as determined through clinical review, with renewal at 6 months.
04Claims without compliant prior authorization will be denied.

Original notice

Erwinase® (asparaginase Erwinia chrysanthemi) (Revised)
mcp.humana.com · Always check the source before changing claims.
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Related changes

See all Humana changes →
Erwinase® (asparaginase Erwinia chrysanthemi) (Revised)MediumEffective Jan 1, 2019 · MedicaidErwinase® (asparaginase Erwinia chrysanthemi) (Revised)MediumEffective Nov 1, 2025 · MedicaidErwinase® (asparaginase Erwinia chrysanthemi) (Revised)MediumEffective Jan 1, 2019 · MedicaidErwinase® (asparaginase Erwinia chrysanthemi) (Revised)MediumEffective Nov 1, 2025 · MedicaidBrowse every Humana change in the policy list

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