Medicare AdvancePrior AuthMedium impact
Juxtapid® (lomitapide) (Revised)
Humana·Cardiology, Internal Medicine·Medicare Advantage
We identified it
Jul 22, 2026
Summary
Humana has revised its Prior Authorization policy for Juxtapid® (lomitapide), a medication used to treat homozygous familial hypercholesterolemia. This is a Medicare Advantage policy update affecting coverage and authorization requirements. The billing team must verify the specific policy details and implement any new prior authorization workflows immediately.
Action Required
Immediately: Billing team must obtain and review the complete Juxtapid® (lomitapide) Prior Authorization policy from the source URL. Contact Humana directly or access their DCTM portal to retrieve full policy details including: (1) specific prior authorization requirements and submission processes, (2) medical necessity criteria, (3) any step therapy or alternative therapy requirements. Update your billing system and prior authorization workflows accordingly. Train providers on new requirements before submitting claims. Failure to obtain prior authorization per updated policy will result in claim denials. Note: This analysis is limited because only a summary was provided—the full policy content is required for complete implementation guidance.