Medicare AdvantagePrior AuthMedium impact
Rubraca (rucaparib) (Revised)
Humana·Oncology, Hematology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for Rubraca (rucaparib), a cancer medication used for ovarian/fallopian tube/peritoneal cancers and metastatic prostate cancer. The policy requires BRCA mutation testing and specific treatment criteria to be met before approval.
Action Required
By January 1, 2026: Prior authorization team must verify BRCA mutation status (germline and/or somatic) and document complete/partial response to platinum-based therapy before submitting Rubraca prior authorization requests for Humana Medicare Advantage members. Ensure Avastin is discontinued before maintenance therapy initiation. Claims without proper documentation will be denied.