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Medicare AdvantagePrior AuthHigh impact

Cosentyx (secukinumab) intravenous solution (Revised)

Humana·Rheumatology, Dermatology, Internal Medicine·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Cosentyx intravenous solution for three conditions: psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. Each condition has specific step therapy requirements with different biologic medications before Cosentyx IV can be approved.

Action Required

Action needed
By January 1, 2025: Billing team must obtain prior authorization for all Cosentyx intravenous solution requests for Humana Medicare Advantage patients. Verify patients have failed required step therapy medications (varies by condition) and document contraindications or intolerances. Update prior auth tracking system to flag these requests. Claims will be denied without proper prior authorization.