MedicaidPrior AuthLow impact
Givlaari® (givosiran) (New)
Humana·IN · Gastroenterology, Hematology, Genetics +1 more·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has introduced a new prior authorization policy for Givlaari (givosiran), a specialty medication used to treat acute hepatic porphyria. The policy requires specific diagnostic confirmation and symptom criteria to be met before approval for this subcutaneous medication.
Action Required
By October 1, 2025: Billing team must update prior authorization procedures for Givlaari (givosiran) claims. Ensure providers document: 1) confirmed diagnosis of acute hepatic porphyria with elevated PBG/ALA or genetic testing, 2) documented symptoms consistent with acute hepatic porphyria, and 3) confirmation that medication will be administered by healthcare professional. Visit www.humana.com/PAL for specific medical and procedural coding information. Claims without proper prior authorization will be denied.