Medicare AdvantagePrior AuthLow impact
Forzinity™ (Elamipretide) (New)
Humana·Cardiology, Pediatrics, Genetics +1 more·Medicare Advantage
Effective date
Feb 25, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established a new prior authorization policy for Forzinity™ (Elamipretide), a drug used to treat the ultra-rare Barth syndrome. Prior authorization is required for all Forzinity prescriptions and requires genetic confirmation of Barth syndrome with TAFAZZIN gene mutations plus patient weight ≥30 kg.
Action Required
By February 25, 2026: Billing and clinical teams must implement prior authorization procedures for Forzinity™ (Elamipretide) prescriptions for Humana Medicare Advantage members. Providers must document genetic confirmation of Barth syndrome via TAFAZZIN gene mutations and verify patient weight ≥30 kg before prescribing. Update prior authorization request forms and EMR templates to include these requirements. Claims will be denied without proper prior authorization.