Medicare AdvantagePrior AuthMedium impact
Talzenna (talazoparib) (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 Talzenna (talazoparib), a PARP inhibitor used for treating BRCA-mutated breast cancer and metastatic castration-resistant prostate cancer. The policy establishes specific criteria for coverage including genetic mutation documentation and combination therapy requirements.
Action Required
Before January 1, 2026: Billing team must update prior authorization processes for Talzenna (talazoparib) prescriptions. Ensure providers document BRCA mutations for breast cancer patients and HRR gene mutations for prostate cancer patients. Verify endocrine refractory status for hormone receptor positive breast cancer cases. Update EMR templates to capture required criteria. Claims will be denied without proper prior authorization approval.