Medicare AdvantagePrior AuthMedium impact
Lifyorli (relacorilant) (Revised)
Humana·Oncology·Medicare Advantage
Effective date
May 27, 2026
We identified it
Jul 21, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for Lifyorli (relacorilant), a glucocorticoid receptor antagonist used in combination with nab-paclitaxel for platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer. The policy requires prior authorization and specifies strict criteria including platinum-resistant disease diagnosis, combination use with nab-paclitaxel, and prior treatment history (1-3 prior systemic therapy lines with at least one including bevacizumab). This is a revision to an existing policy effective May 27, 2026.
Action Required
By July 22, 2026 (revision date): Billing and prior authorization teams must ensure the updated Lifyorli prior authorization requirements are configured in billing systems. Specifically: (1) Verify that all Lifyorli (relacorilant) claims for Medicare Advantage members require prior authorization before processing; (2) Update prior authorization request forms to capture all four approval criteria: diagnosis of platinum-resistant epithelial ovarian/fallopian tube/primary peritoneal cancer, platinum-resistant disease status, combination use with nab-paclitaxel, and prior treatment history (1-3 regimens with at least one containing bevacizumab); (3) Train clinical review staff on the revised criteria; (4) Configure billing system rules to route all Lifyorli requests to prior authorization queue; (5) Communicate requirements to oncology providers and practices. Claims submitted without meeting these criteria or without prior authorization will be denied. Refer to www.humana.com/PAL for applicable medical and procedural coding information.