Medicare AdvantagePrior AuthMedium impact
FILSPARI® (sparsentan) (Revised)
Humana·Nephrology, Internal Medicine·Medicare Advantage
We identified it
Jul 22, 2026
Summary
Humana has issued a revised Prior Authorization policy for FILSPARI® (sparsentan), a medication for Medicare Advantage members. This is a brand-new policy (1 day old) that requires immediate review to understand updated authorization requirements and implement necessary billing workflow changes.
Action Required
IMMEDIATE: Billing and clinical teams must obtain and review the complete FILSPARI® (sparsentan) Prior Authorization policy from Humana at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a586820. Once reviewed, identify the specific J-code for sparsentan injection and update billing system to flag all sparsentan claims for prior authorization before submission. Communicate revised authorization criteria to prescribers and update any internal protocols for medication prior auth requests. Failure to obtain prior authorization for Medicare Advantage members will result in claim denials. Confirm effective date and implementation timeline directly with Humana.