Medicare AdvantagePrior AuthLow impact
Crenessity® (crinecerfont) (Revised)
Humana·Endocrinology, Pediatrics·Medicare Advantage
Effective date
May 28, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established a new prior authorization policy for Crenessity (crinecerfont), a medication used to treat classic congenital adrenal hyperplasia (CAH). Prior authorization will be required starting May 28, 2025, with specific criteria including CAH diagnosis, continued glucocorticoid therapy, and prescription by an endocrinologist or CAH specialist.
Action Required
Before May 28, 2025: Billing team must update prior authorization processes for Crenessity (crinecerfont) prescriptions for Humana Medicare Advantage patients. Ensure providers document: 1) Classic CAH diagnosis, 2) Continued glucocorticoid replacement therapy, and 3) Prescription by endocrinologist or CAH specialist. Update encounter forms and EMR templates to capture required criteria. Claims without prior authorization will be denied.