Medicare AdvantagePrior AuthMedium impact
Non-Preferred Filgrastim Products: Neupogen, Nypozi, Releuko, Filkri (Revised)
Humana·Hematology, Oncology, Infectious Disease +1 more·Medicare Advantage
We identified it
Jul 14, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for non-preferred filgrastim products (Neupogen, Nypozi, Releuko, Filkri). This is a very recent policy update (1 day old) that establishes prior authorization requirements for these specific colony-stimulating factor medications on Medicare Advantage plans. Billing teams must verify prior authorization is obtained before claims submission to avoid denials.
Action Required
Immediately: Billing team must implement prior authorization verification process for filgrastim products (Neupogen, Nypozi, Releuko, Filkri) on all Humana Medicare Advantage claims. Update billing software to flag claims containing J1440, J1441, J1442, or J1443 and require documentation of prior authorization before submission. Coordinate with providers and clinical staff to ensure prior authorization requests are submitted to Humana before drug administration or dispensing. Claims submitted without prior authorization will be subject to denial. Verify the specific effective date by accessing the full policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a57b94f.