Medicare AdvantagePrior AuthMedium impact
Brinsupri™ (brensocatib) (New)
Humana·Pulmonology·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has introduced a new prior authorization policy for Brinsupri (brensocatib), a medication used to treat non-cystic fibrosis bronchiectasis. The policy requires specific diagnostic criteria including CT confirmation, pulmonologist consultation, and documented exacerbation history before approval.
Action Required
By November 26, 2025: Billing team and providers must establish prior authorization workflow for Brinsupri (brensocatib) prescriptions for Humana Medicare Advantage patients. Ensure documentation includes: NCFB diagnosis confirmed by chest CT, pulmonologist prescription/consultation, and patient exacerbation history (2+ exacerbations for ages 18+, 1+ for ages 12-17 in past 12 months). Update EMR templates to capture required criteria. Claims will be denied without proper prior authorization.