Medicare AdvantagePrior AuthMedium impact
Cardamyst™ (etripamil) (New)
Humana·Cardiology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Feb 25, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Cardamyst (etripamil) nasal spray for treating paroxysmal supraventricular tachycardia (PSVT) in Medicare Advantage plans. Requires diagnosis of PSVT, history of sustained episodes, specialist involvement, and previous failure/intolerance to oral medications.
Action Required
By February 25, 2026: Billing and clinical teams must implement prior authorization requirements for Cardamyst (etripamil) nasal spray prescriptions. Update EMR templates to document PSVT diagnosis, episode duration >20 minutes, cardiologist involvement, and previous treatment failures with oral calcium channel blockers or beta-blockers. Verify patients do not have heart failure NYHA Class II-IV before prescribing. Claims will be denied without proper prior authorization.