Medicare AdvantagePrior AuthLow impact
Attruby™ (acoramidis) (Revised)
Humana·Cardiology·Medicare Advantage
Effective date
Feb 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Attruby (acoramidis), a new medication for transthyretin-mediated amyloid cardiomyopathy. Coverage requires specialist treatment, specific heart failure criteria, confirmed ATTR-CM diagnosis, and exclusion of certain transplant/device history.
Action Required
By February 26, 2025: Billing team must ensure prior authorization is obtained for all Attruby (acoramidis) prescriptions for Medicare Advantage patients. Verify patients meet all four criteria: specialist treatment, NYHA Class I-III heart failure history, confirmed ATTR-CM diagnosis, and no history of liver/heart transplant or LVAD. Claims will be denied without proper prior authorization.