MedicaidPrior AuthLow impact
Amvuttra™ (vutrisiran) (Revised)
Humana·OH · Cardiology, Neurology, Genetics·Medicaid
Effective date
Jul 1, 2025
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Amvuttra (vutrisiran) injections for treating hereditary transthyretin-mediated amyloidosis affecting heart and nervous system. Specific criteria required including genetic testing, specialist treatment, and exclusion of transplant history.
Action Required
By July 1, 2025: Update prior authorization procedures for Amvuttra (vutrisiran) subcutaneous injections. Ensure providers document TTR gene mutation, comprehensive neurologic examination results, polyneuropathy disability scores, and transplant history. Verify cardiomyopathy patients are treated by specialists with NYHA Class I-III heart failure documentation. Claims will be denied without proper prior authorization.