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HumanaMedicaid · Prior Auth · Medicaid · IN · Oncology, HematologyMedium impact

Erwinase® (asparaginase Erwinia chrysanthemi) (Revised)

Effective date
Nov 1, 2025
Identified
Oct 6, 2026

Summary

This is a historical prior authorization policy for Erwinase (asparaginase Erwinia chrysanthemi) for Medicaid Indiana members with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to prior asparaginase treatment. The policy was originally effective November 1, 2025, and was revised July 22, 2026. Since this source was newly discovered on October 6, 2026 (analysis date), the policy is already in effect; verify current applicability with Humana rather than treating this as a pending change.

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What to do

Action · 5 steps
01Already effective 2025-11-01: Verify whether the practice currently manages Erwinase prior authorization requests according to this policy.
02For Indiana Medicaid members seeking Erwinase coverage, the billing and clinical teams should confirm the following criteria are documented before claim submission: (1) member has ALL diagnosis, (2) documented Grade 2–4 hypersensitivity to prior Oncaspar (pegaspargase) therapy, and (3) Erwinase is part of multi-agent chemotherapy.
03Deny requests if member has exclusionary history (serious pancreatitis, thrombosis, hemorrhagic events, or disease progression on prior asparaginase therapy).
04Initial and renewal approvals are valid for 6 months or as determined by clinical review.
05Refer to Humana's Medical and Pharmacy Coverage Policies portal (www.humana.com/PAL) to confirm this is the current version before utilizing, as Humana updates policies regularly and printed copies become uncontrolled.

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)LowEffective 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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