Medicare AdvantagePrior AuthLow impact
Torisel (temsirolimus) (Revised)
Humana·Oncology·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated its prior authorization policy for Torisel (temsirolimus) injections used to treat advanced renal cell carcinoma. The policy requires prior authorization with specific criteria including stage IV diagnosis and excludes patients who have experienced disease progression while on the medication.
Action Required
Billing team must ensure prior authorization is obtained for all Torisel (temsirolimus) IV solution claims for Humana Medicare Advantage patients with advanced renal cell carcinoma. Verify patient meets stage IV diagnosis criteria and has not experienced disease progression on this medication before submitting prior auth requests. Claims without proper prior authorization will be denied.