Medicare AdvantagePrior AuthLow impact
Qinlock (ripretinib) (Revised)
Humana·Oncology, Gastroenterology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Qinlock (ripretinib) used to treat advanced gastrointestinal stromal tumors (GIST). Approval requires documentation of advanced GIST diagnosis, prior therapy with three or more kinase inhibitors including imatinib, and monotherapy use.
Action Required
By January 1, 2026: Billing team must obtain prior authorization for all Qinlock (ripretinib) prescriptions for Medicare Advantage patients. Ensure providers document advanced GIST diagnosis, prior therapy with three or more kinase inhibitors including imatinib, and monotherapy use. Visit www.humana.com/PAL for preauthorization requirements. Claims will be denied without prior authorization.