CommercialPrior AuthMedium impact
Astagraf XL (tacrolimus extended release) (Revised)
Humana·Nephrology, Transplant Surgery·Commercial
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has revised its prior authorization policy for Astagraf XL (tacrolimus extended release) for kidney transplant patients. The policy requires prior authorization with strict criteria including prior therapy with or intolerance to immediate-release tacrolimus AND Envarsus XR before approving Astagraf XL.
Action Required
Immediately: Billing and clinical teams must ensure prior authorization is obtained for all Astagraf XL prescriptions for kidney transplant patients. Verify patients meet all four criteria: kidney transplant recipient, using for organ rejection prophylaxis, using with other immunosuppressants, and have tried or cannot tolerate both immediate-release tacrolimus AND Envarsus XR. Document all criteria in prior auth requests. Claims will be denied without proper authorization.