Medicare AdvantagePrior AuthLow impact
Adzynma (ADAMTS13, Recombinant-krhn) (Revised)
Humana·KY, SC · Hematology, Oncology·Medicaid
Effective date
Apr 24, 2024
We identified it
Jun 24, 2026
Summary
Humana has revised their prior authorization policy for Adzynma (ADAMTS13, recombinant-krhn) for treating congenital thrombotic thrombocytopenic purpura (cTTP). The policy requires strict diagnostic criteria including plasma ADAMTS-13 activity <10%, confirmed genetic mutations, and repeated negative antibody testing.
Action Required
Immediately: Review current patients receiving Adzynma to ensure prior authorization compliance. For new Adzynma requests, obtain prior authorization demonstrating: 1) cTTP diagnosis, 2) plasma ADAMTS-13 activity <10 IU/dL, 3) confirmed ADAMTS13 mutation via genetic testing, and 4) repeated negative ADAMTS13 antibody tests. Contact Humana at www.humana.com/PAL for medical billing preauthorization requirements.