Medicare AdvantagePrior AuthMedium impact
Livtencity (maribavir) tablet (Revised)
Humana·Infectious Disease, Transplant Surgery, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 19, 2022
We identified it
Jun 25, 2026
Summary
This is a revised Humana Medicare Advantage prior authorization policy for Livtencity (maribavir) effective January 19, 2022, with the most recent revision dated March 25, 2026. The policy requires prior authorization for this CMV treatment drug and specifies two strict approval criteria: patient must have post-transplant CMV infection AND be refractory to ganciclovir, valganciclovir, cidofovir, or foscarnet. Critical warnings include drug interaction risks with immunosuppressants (tacrolimus, cyclosporine, sirolimus, everolimus) requiring frequent monitoring.
Action Required
By March 25, 2026 (policy revision date): Billing and clinical teams must ensure all Livtencity (maribavir) requests include documentation of: (1) post-transplant CMV diagnosis, and (2) documented refractoriness to at least one prior CMV therapy (ganciclovir, valganciclovir, cidofovir, or foscarnet). Verify prior authorization is obtained BEFORE dispensing—claims will be denied without documented prior auth approval. Update encounter templates and prior auth submission forms to require evidence of treatment failure. Provide providers with the critical drug interaction alert: flag all claims where patient is on tacrolimus, cyclosporine, sirolimus, or everolimus concurrently, and ensure ordering physicians document immunosuppressant level monitoring plans. Route all initial and renewal requests through Humana's PAL system (www.humana.com/PAL) for medical/procedural coding requirements.