MedicaidPrior AuthLow impact
Fyarro (sirolimus protein-bound particles for injectable suspension) (Revised)
Humana·OH · Oncology, Pharmacy·Pharmacy
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Fyarro (sirolimus protein-bound particles for injectable suspension) effective November 26, 2025, for Ohio Medicaid patients with perivascular epithelioid cell tumors. Prior authorization is required for this specialized cancer treatment with specific clinical criteria.
Action Required
By November 26, 2025: Billing team must update prior authorization requirements for Fyarro (sirolimus protein-bound particles for injectable suspension) for Ohio Medicaid patients. Ensure providers document locally advanced unresectable or metastatic perivascular epithelioid cell tumor diagnosis and monotherapy administration before treatment. Claims will be denied without proper prior authorization.