Medicare AdvantagePrior AuthLow impact
Filsuvez® (birch triterpenes) (Revised)
Humana·Dermatology, Wound Care, Pediatrics·Medicare Advantage
Effective date
May 22, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Filsuvez (birch triterpenes) topical gel used to treat dystrophic and junctional epidermolysis bullosa. The policy requires genetic testing confirmation, specialist prescribing, and documentation submission for approval.
Action Required
Immediately: Billing team must obtain prior authorization from Humana before prescribing or billing for Filsuvez (birch triterpenes) topical gel for Medicare Advantage patients. Ensure dermatologists have genetic testing results confirming DEB or JEB diagnosis and submit required documentation including chart notes and genetic testing results. Patient must be 6+ months old and receiving concurrent wound care. Visit www.humana.com/PAL for specific preauthorization requirements.