Medicare AdvantagePrior AuthLow impact
Aemcolo™ (rifamycin) (Revised)
Humana·Family Medicine, General Practice, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana revised its prior authorization policy for Aemcolo™ (rifamycin) for Medicare Advantage members with travelers' diarrhea. The policy requires prior auth with specific criteria including failed/contraindicated treatment with ciprofloxacin, levofloxacin, or azithromycin, and confirmation that the condition is not complicated by fever or blood in stool.
Action Required
Immediately: Billing team must ensure prior authorization is obtained before prescribing Aemcolo™ (rifamycin) for Medicare Advantage members. Providers must document that patient has travelers' diarrhea caused by non-invasive E. coli, no fever or bloody stool, and has failed/cannot tolerate ciprofloxacin, levofloxacin, or azithromycin. Update pharmacy prior auth workflows to verify these criteria are met before submission.