Medicare AdvantagePrior AuthMedium impact
Rydapt® (midostaurin) (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for Rydapt (midostaurin), a cancer medication used for acute myeloid leukemia and systemic mastocytosis. The policy specifies detailed criteria including FLT3 mutation testing requirements and excludes post-consolidation therapy use.
Action Required
Before January 1, 2026: Oncology and hematology providers must obtain prior authorization for Rydapt (midostaurin) prescriptions for Medicare Advantage members. Ensure documentation includes FLT3 mutation-positive test results, specific AML diagnosis type (newly diagnosed vs relapsed/refractory), or systemic mastocytosis subtype (ASM, SM-AHN, or MCL). Update EMR templates to capture required criteria and exclusions. Claims will be denied without proper prior authorization.