Medicare AdvantagePrior AuthLow impact
Actimmune® (interferon gamma-1b) (Revised)
Humana·Allergy & Immunology, Hematology, Oncology +2 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage updated their prior authorization policy for Actimmune (interferon gamma-1b) effective January 1, 2025. The policy requires prior auth for this specialty medication used to treat Chronic Granulomatous Disease and Severe Malignant Osteopetrosis, with specific criteria that must be met for approval.
Action Required
By January 1, 2025: Billing team must obtain prior authorization from Humana Medicare Advantage before prescribing or billing for Actimmune (interferon gamma-1b). Ensure providers document diagnosis of either Chronic Granulomatous Disease or Severe Malignant Osteopetrosis and appropriate clinical use. Claims will be denied without proper prior authorization.