Medicare AdvantagePrior AuthMedium impact
DPP-IV inhibitors (New)
Humana·Endocrinology, 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 DPP-IV inhibitors (diabetes medications including Nesina, Oseni, Kazano, Zituvio, sitagliptin, saxagliptin, and Brynovin). Members must have tried or have contraindications to preferred alternatives (Januvia/Janumet/Janumet XR AND Tradjenta/Jentadueto/Jentadueto XR) before approval.
Action Required
By January 1, 2026: Billing team must implement prior authorization workflow for all DPP-IV inhibitor prescriptions for Humana Medicare Advantage patients. Providers must document previous treatment with, contraindication to, or intolerance to both Januvia/Janumet/Janumet XR AND Tradjenta/Jentadueto/Jentadueto XR before prescribing covered alternatives. Update EMR templates to capture required documentation. Prescriptions without prior authorization will be denied.