Xifaxan (rifaximin) prior authorization/medical necessity
UnitedHealthcare prior authorization program defining coverage criteria, initial and reauthorization rules, and supply/authorization durations for Xifaxan (rifaximin) for travelers' diarrhea, hepatic encephalopathy recurrence prevention, and irritable bowel syndrome with diarrhea (IBS-D). Applies to members subject to plan and state mandates; automated approval based on claims history may be used.
Annual review July 2025; removed inflammatory bowel disease due to limited data available and updated references.
Program effective date updated to 10/1/2025 and P&T approval dates listed through 7/2025.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.