MedicaidPrior AuthMedium impact
Korsuva™ (difelikefalin) (New)
Humana·FL, KY, SC · Nephrology, Internal Medicine·Medicaid
Effective date
May 27, 2026
We identified it
Jun 24, 2026
Summary
Humana introduces a new prior authorization policy for Korsuva (difelikefalin), an IV medication for severe itching in chronic kidney disease patients on hemodialysis. The policy requires specific criteria including CKD diagnosis with pruritus and consistent hemodialysis 3x weekly for 3 months before approval.
Action Required
Before May 27, 2026: Billing team must update prior authorization workflows for Korsuva (difelikefalin) IV infusions. Ensure providers document CKD-associated pruritus diagnosis and confirm patients have undergone hemodialysis 3x weekly for 3 months before submitting auth requests. Visit www.humana.com/PAL for applicable medical procedure codes. Initial approvals are for 6 months; renewals require documented efficacy showing decreased pruritus.