Medicare AdvantagePrior AuthLow impact
Strensiq® (asfotase alfa) (Revised)
Humana·KY, SC · Endocrinology, Pediatrics, Genetics·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Strensiq (asfotase alfa) effective January 1, 2025, for Medicare and Medicaid plans in Kentucky and South Carolina. The policy requires specific diagnostic criteria including gene mutations or biochemical markers for hypophosphatasia patients with onset before age 18.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Strensiq (asfotase alfa) prescriptions for Medicare and Medicaid patients in Kentucky and South Carolina. Verify patients meet diagnostic criteria including clinical/radiographic evidence of hypophosphatasia onset before age 18 plus documented gene mutation or specific laboratory values. Claims will be denied without proper prior authorization.