Medicare AdvantagePrior AuthMedium impact
Akynzeo (fosnetupitant-palonosetron/netupitant- palonosetron) (Revised)
Humana·Oncology, Palliative Care·Medicare Advantage
We identified it
Jul 1, 2026
Summary
This is a revised Prior Authorization policy for Akynzeo (fosnetupitant-palonosetron/netupitant-palonosetron) affecting Medicare Advantage members. The policy update requires prior authorization for this anti-nausea medication. Specific coverage criteria, effective date, and detailed requirements cannot be determined from the summary-only content provided.
Action Required
Immediately: Billing and clinical teams must obtain the full policy document from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5e8) to identify specific HCPCS codes for Akynzeo formulations and exact prior authorization requirements. Once full policy details are available, update prior authorization workflows in billing software and provider encounter systems. Ensure all staff submitting claims for Akynzeo to this Medicare Advantage plan follow the new authorization procedures. Failure to obtain required prior authorization will result in claim denials.