Medicare AdvantagePrior AuthLow impact
Gomekli (mirdametinib) (Revised)
Humana·Neurology, Oncology, Pediatrics·Medicare Advantage
Effective date
May 28, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has implemented a new prior authorization policy for Gomekli (mirdametinib), a kinase inhibitor used to treat neurofibromatosis type 1 (NF1) with symptomatic plexiform neurofibromas. Prior authorization is required for both capsule and tablet formulations, with specific criteria requiring symptomatic plexiform neurofibromas not amenable to complete resection.
Action Required
Before May 28, 2025: Billing and clinical teams must obtain prior authorization from Humana Medicare Advantage before prescribing Gomekli (mirdametinib) for NF1 patients. Verify patient meets both criteria: (1) symptomatic plexiform neurofibromas and (2) disease not amenable to complete resection. Visit www.humana.com/PAL for specific prior authorization forms and medical coding requirements. Claims submitted without prior authorization will be denied.