Medicare AdvantagePrior AuthMedium impact
Briumvi™ (ublituximab) (Revised)
Humana·FL, KY, SC · Neurology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has revised its prior authorization policy for Briumvi (ublituximab), an IV medication for multiple sclerosis. The policy now requires step therapy with at least two other MS medications before approval for Medicare plans, but exempts Medicaid from step therapy requirements.
Action Required
By January 1, 2026: Review current Briumvi (ublituximab) prescriptions for Medicare patients to ensure step therapy requirements are met. Update prior authorization workflows to document trial/contraindication of at least two specified MS medications for Medicare Part D requests, or Ocrevus for Medicare Part B requests. Medicaid patients are exempt from step therapy. Verify patient insurance type before submitting prior auth requests.