Medicare AdvantagePrior AuthLow impact
Revuforj® (revumenib) (Revised)
Humana·Hematology, Oncology, Pediatrics·Medicare Advantage
Effective date
Feb 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Revuforj (revumenib), a new leukemia medication, effective February 26, 2025. The drug requires specific genetic mutations and disease status documentation for approval.
Action Required
By February 26, 2025: Billing team must ensure prior authorization is obtained before prescribing Revuforj (revumenib) for Medicare Advantage patients with acute leukemia. Providers must document KMT2A mutations or NPM1 mutations with susceptibility testing results. Claims will be denied without proper prior authorization.