Medicare AdvantagePrior AuthMedium impact
Xpovio® (selinexor) (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 28, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage revised its Xpovio (selinexor) prior authorization policy effective January 28, 2026. The policy maintains coverage for multiple myeloma (MM) under two treatment pathways: (1) as monotherapy after 4+ prior therapies with specific refractoriness criteria, or (2) in combination with bortezomib and dexamethasone after 1+ prior therapy. It also covers relapsed/refractory DLBCL after 2+ lines of systemic therapy as monotherapy. Prior authorization is required for all uses, and claims will be denied if members have experienced disease progression on selinexor.
Action Required
By January 28, 2026: Billing team must update prior authorization workflows in the billing system to reflect the revised Xpovio (selinexor) coverage criteria for both multiple myeloma and DLBCL indications. When submitting prior authorization requests for Xpovio, verify that patients meet the specific clinical criteria (treatment history, disease refractoriness, and combination therapy requirements) outlined in the policy before submission. Update internal clinical documentation templates and provider communication materials to reference the new revision date (1/28/2026). Reject any prior authorization requests for patients with documented disease progression on selinexor, as these are now explicitly excluded from coverage. Communicate the revised criteria to oncology providers in the network to ensure they understand the updated treatment pathway options before submitting authorizations. Failure to apply the correct criteria may result in claim denials or rework.