Medicare AdvantagePrior AuthLow impact
Eulexin (Flutamide) (Revised)
Humana·Oncology, Urology·Medicare Advantage
Effective date
Jan 1, 2023
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for Eulexin (Flutamide), a nonsteroidal antiandrogen used to treat prostate cancer. The policy requires prior authorization when flutamide is used alone or in combination with LHRH analogs, with coverage limited to members with a confirmed prostate cancer diagnosis. This is a routine policy revision with no substantive coverage changes from the effective date.
Action Required
No immediate action required. This is a revised policy document with an effective date of January 1, 2023 (already in effect). Verify that your billing system is configured to require prior authorization for Eulexin (flutamide) claims for Medicare Advantage members. If your practice prescribes this medication, confirm that providers are documenting prostate cancer diagnosis and treatment regimen (monotherapy vs. combination with LHRH analog) in clinical notes to support prior authorization requests. Reference the updated policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a4cad65 for any new submissions.