Medicare AdvantagePrior AuthLow impact
Tretten® (Coagulation Factor XIII A-Subunit [Recombinant]) (Revised)
Humana·KY, SC · Hematology, Internal Medicine, Pediatrics·Medicaid
Effective date
Dec 17, 2025
We identified it
Jun 25, 2026
Summary
Humana revised its Tretten® (Coagulation Factor XIII A-Subunit [Recombinant]) prior authorization policy effective December 17, 2025. This is a pharmacy coverage policy requiring prior authorization for Tretten use in patients with congenital factor XIII A-subunit deficiency for routine prophylaxis of bleeding. The policy applies to Medicare and Medicaid (Kentucky and South Carolina) plans.
Action Required
By December 17, 2025: Billing and clinical staff must ensure all Tretten requests for congenital factor XIII A-subunit deficiency patients include prior authorization. Update prior authorization workflows to require documentation that the member has a confirmed diagnosis of congenital factor XIII A-subunit deficiency and will use Tretten for routine prophylaxis of bleeding. Verify member eligibility under Medicare or Medicaid (KY/SC only). Note: This is a rare specialty medication; ensure prescribers submit claims through www.humana.com/PAL for applicable preauthorization codes. Claims submitted without prior authorization will be denied.