Medicare AdvantagePrior AuthMedium impact
Colchicine Products (Revised)
Humana·Rheumatology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Mar 25, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for brand-name colchicine products (Gloperba, Colcrys, Mitigare) used for gout flare prophylaxis. Members must have gout diagnosis, failed previous colchicine tablet treatment, and meet specific criteria including contraindication to urate lowering therapy.
Action Required
By March 25, 2026: Billing team must update prior authorization processes for brand-name colchicine products (Gloperba, Colcrys, Mitigare) for Humana Medicare Advantage members. Providers must document gout diagnosis, previous colchicine tablet failure, and contraindication to urate lowering therapy. Update encounter forms to prompt for required documentation. Claims without prior authorization will be denied.