Medicare AdvantagePrior AuthLow impact
Fintepla® (fenfluramine) (Revised)
Humana·Neurology, Pediatrics·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana revised their prior authorization policy for Fintepla (fenfluramine), a medication used to treat seizures in Dravet Syndrome and Lennox-Gastaut Syndrome patients aged 2 and older. The policy requires specialist prescribing and evidence of failed treatment with other seizure medications before approval.
Action Required
When submitting prior authorization requests for Fintepla (fenfluramine) for Humana Medicare Advantage and Commercial members: Ensure documentation includes (1) diagnosis of Dravet Syndrome or Lennox-Gastaut Syndrome, (2) prescription by neurologist or epileptologist, and (3) evidence of failed seizure control with at least one other appropriate medication. Note that this medication requires REMS program enrollment due to cardiac risks.