Medicare AdvantagePrior AuthMedium impact
Jascayd® (nerandomilast) (Revised)
Humana·Pulmonology, Internal Medicine·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Jascayd (nerandomilast) tablets for treating Idiopathic Pulmonary Fibrosis (IPF) and Progressive Pulmonary Fibrosis (PPF) in Medicare Advantage plans. Requires specific diagnostic criteria and documented failure/intolerance to first-line treatments like Ofev or pirfenidone before approval.
Action Required
By November 26, 2025: Billing and clinical teams must implement prior authorization requirements for Jascayd (nerandomilast) prescriptions for Medicare Advantage patients. Ensure providers document pulmonary fibrosis diagnosis via CT scan or lung biopsy, rule out environmental causes, and demonstrate previous treatment failure/contraindication to Ofev or pirfenidone. Update pharmacy prior auth workflows to capture these clinical criteria or claims will be denied.