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Medicare AdvantagePrior AuthLow impact

Harliku™ (nitisinone) (New)

Humana·Genetics, Endocrinology, Family Medicine +1 more·Medicare Advantage
Effective date
Sep 24, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Harliku (nitisinone) tablets used to treat alkaptonuria, a rare genetic disorder. Coverage requires confirmed diagnosis through genetic testing or elevated urine homogentistic acid levels.

Action Required

Action needed
By September 24, 2025: Billing team must ensure prior authorization is obtained before prescribing or billing for Harliku (nitisinone) tablets for Medicare Advantage patients with alkaptonuria. Verify patient meets diagnostic criteria through genetic testing or elevated urine HGA levels. Submit prior auth requests through www.humana.com/PAL. Claims will be denied without proper authorization.