Medicare AdvantagePrior AuthLow impact
Aqneursa™ (levacetylleucine) (Revised)
Humana·Neurology, Genetics, Pediatrics·Medicare Advantage
Effective date
Mar 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage plans now require prior authorization for Aqneursa (levacetylleucine), a new medication for treating Niemann-Pick disease type C. The drug requires strict eligibility criteria including confirmed genetic diagnosis, minimum weight of 15kg, and prescription by a specialist.
Action Required
By March 26, 2025: Billing and clinical teams must obtain prior authorization from Humana Medicare Advantage plans before prescribing Aqneursa (levacetylleucine). Ensure providers document all five required criteria: confirmed NPC diagnosis with genetic testing or biomarker evidence, patient weight ≥15kg, neurological symptoms, and specialist consultation. Visit www.humana.com/PAL for specific medical coding requirements. Claims without prior authorization will be denied.