Medicare AdvantagePrior AuthMedium impact
Hyrnuo (sevabertinib) (New)
Humana·Oncology, Pulmonology·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 Hyrnuo (sevabertinib), a cancer drug for treating HER2-mutated non-small cell lung cancer. Prior authorization will be required starting February 25, 2026, with specific criteria including diagnosis confirmation, genetic testing results, and prior systemic therapy documentation.
Action Required
Before February 25, 2026: Billing and clinical teams must implement prior authorization requirements for Hyrnuo (sevabertinib) prescriptions for Humana Medicare Advantage patients. Ensure documentation includes: locally advanced/metastatic non-squamous NSCLC diagnosis, HER2 (ERBB2) TKD mutation test results, prior systemic therapy records, and confirmation of monotherapy use. Update EMR templates and prior auth workflows to capture these requirements. Claims will be denied without proper prior authorization.