Medicare AdvantagePrior AuthMedium impact
Apokyn® (apomorphine) (Revised)
Humana·Neurology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Apokyn (apomorphine) prescriptions used to treat Parkinson's disease 'off' episodes. Patients must meet three specific criteria including confirmed Parkinson's diagnosis, concurrent carbidopa/levodopa use, and experiencing breakthrough 'off' periods.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflow for Apokyn (apomorphine) prescriptions for Humana Medicare Advantage members. Providers must verify patients meet all three criteria: (1) Parkinson's disease diagnosis, (2) current carbidopa/levodopa use with plan to continue, and (3) experiencing breakthrough 'off' periods. Update encounter forms to include these documentation requirements. Claims without prior authorization will be denied.