Medicare AdvantagePrior AuthMedium impact
Rezlidhia (olutasidenib) (Revised)
Humana·Hematology, Oncology·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage updated its Rezlidhia (olutasidenib) pharmacy coverage policy on November 26, 2025. The policy requires prior authorization for this IDH1 inhibitor used to treat relapsed/refractory acute myeloid leukemia (AML). Coverage requires documented IDH1 mutation, monotherapy use, and approval for initial 6-month periods with 6-month renewals. Claims will be denied without meeting all four clinical criteria and absence of exclusions.
Action Required
By December 26, 2025: Billing and prior authorization teams must implement new prior authorization workflow for Rezlidhia (olutasidenib) in the billing system and EMR. Providers must verify at the point of prescribing that: (1) patient has documented AML diagnosis, (2) disease is relapsed or refractory, (3) IDH1 mutation confirmed by FDA-approved test, and (4) drug will be used as monotherapy. Front desk and authorization staff must flag any claims lacking documentation of IDH1 mutation status or monotherapy confirmation. Set approval duration reminders for initial 6-month approvals and automatic renewal requests at 5.5 months. Educate hematology/oncology providers that claims without prior authorization or missing any of the four required criteria will be denied. Monitor for exclusion: deny or escalate any continuation requests after documented disease progression on Rezlidhia.