Medicare AdvantagePrior AuthMedium impact
Ensacove (ensartinib) (New)
Humana·Oncology, Pulmonology·Medicare Advantage
Effective date
Feb 25, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has introduced a new prior authorization policy for Ensacove (ensartinib), a targeted cancer therapy for ALK-positive non-small cell lung cancer. This new drug requires prior authorization with specific criteria including documented ALK-positive status and medical justification for why first-line therapies cannot be used.
Action Required
Before February 25, 2026: Billing and clinical teams must establish prior authorization workflow for Ensacove (ensartinib) prescriptions for Medicare Advantage patients. Providers must document: 1) locally advanced or metastatic NSCLC diagnosis, 2) ALK-positive test results, 3) medical justification why Alecensa or Alunbrig cannot be used as first-line therapy, and 4) confirmation of monotherapy use. Update EMR templates and prior auth checklists to include these requirements. Claims will be denied without proper prior authorization.