Medicare AdvantagePrior AuthMedium impact
Varubi (rolapitant) (Revised)
Humana·Oncology, Pharmacy·Medicare Advantage
We identified it
Jul 2, 2026
Summary
This is a revised Prior Authorization policy for Varubi (rolapitant), a medication used for chemotherapy-induced nausea and vomiting (CINV) prevention in Medicare Advantage members. The policy update requires billing teams to verify prior authorization requirements before dispensing or administering this drug; failure to obtain authorization will result in claim denials for Medicare Advantage beneficiaries.
Action Required
Immediately: Billing and pharmacy teams must verify that all Varubi (rolapitant) claims for Medicare Advantage members require prior authorization before submission. Update claim submission workflows in billing software to flag HCPCS code J2407 for mandatory prior auth verification. Notify oncology providers and infusion centers that Varubi administration requires pre-authorization. Obtain the complete authorization criteria from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5f0) and implement approval requirements in your authorization tracking system. Claims submitted without documented prior authorization approval will be denied by Humana Medicare Advantage plans.