Medicare AdvantagePrior AuthMedium impact
Corlanor® (ivabradine) (New)
Humana·Cardiology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has implemented a new prior authorization policy for Corlanor® (ivabradine) effective January 1, 2026. This medication requires prior auth for heart failure treatment in both adult and pediatric patients, with specific clinical criteria including heart rate thresholds, ejection fraction limits, and documentation of beta-blocker intolerance.
Action Required
By January 1, 2026: Billing team must update prior authorization workflows for Corlanor® (ivabradine) prescriptions for Humana Medicare Advantage members. Providers must document NYHA Class II-IV heart failure, LVEF ≤35% (adults) or ≤45% (pediatrics), specific heart rate thresholds by age, blood pressure ≥90/50 mmHg, and beta-blocker intolerance/contraindication before prescribing. Front desk staff should verify prior auth status before dispensing. Claims without prior authorization will be denied.