Medicare AdvantageCoverageMedium impact
Genetic Testing for Hereditary Cardiovascular Disease - Medicare Advantage (Revised)
Humana·Cardiology, Genetics, Family Medicine +1 more·Medicare Advantage
Effective date
Sep 2, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised their genetic testing policy for hereditary cardiovascular disease, effective September 2, 2025. The policy establishes coverage determination criteria for genetic testing related to inherited cardiomyopathies, channelopathies, familial hypercholesterolemia, and Marfan syndrome, requiring compliance with CMS guidelines and applicable Local Coverage Determinations.
Action Required
Before September 2, 2025: Billing team must review and update genetic testing procedures for cardiovascular conditions to ensure compliance with Humana Medicare Advantage requirements. Verify that genetic testing orders meet CMS analytical and clinical validity standards per applicable Local Coverage Determinations. Update prior authorization workflows to reference the new policy number HUM-1102-006 for genetic testing related to cardiomyopathies, channelopathies, familial hypercholesterolemia, and Marfan syndrome.