Medicare AdvantagePrior AuthMedium impact
Truqap (capivasertib) (Revised)
Humana·Oncology·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new prior authorization requirements for Truqap (capivasertib), a cancer medication for HR+/HER2- metastatic breast cancer. The policy requires specific genetic testing documentation and proof of disease progression before approval.
Action Required
Effective January 1, 2025: Oncology providers must obtain prior authorization before prescribing Truqap (capivasertib) for Humana Medicare Advantage patients. Document all five criteria including metastatic breast cancer diagnosis, HR+/HER2- status, FDA-approved genetic testing results for PIK3CA/AKT1/PTEN alterations, progression on prior CDK 4/6 inhibitor therapy, and concurrent fulvestrant use. Submit prior authorization requests through www.humana.com/PAL. Claims will be denied without prior authorization approval.