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Medicare AdvantagePrior AuthMedium impact

Nucynta IR (tapentadol) tablet (Revised)

Humana·Pain Management, Family Medicine, Internal Medicine +3 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires step therapy for Nucynta IR (tapentadol) tablets, effective January 1, 2026. Members must have failed, had contraindications, or intolerance to TWO of three specific immediate release opioids (oxycodone, hydromorphone, or morphine) before Nucynta will be covered.

Action Required

Action needed
By January 1, 2026: Providers prescribing Nucynta IR (tapentadol) for Humana Medicare Advantage patients must document previous treatment failure, contraindication, or intolerance to TWO of the following opioids: oxycodone, hydromorphone, or morphine. Update EMR templates to include this step therapy documentation. Prescriptions without proper documentation will require prior authorization and may be denied.