Medicare AdvantagePrior AuthMedium impact
Pennsaid (diclofenac topical solution) (New)
Humana·Orthopedics, Rheumatology, Family Medicine +3 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Pennsaid (diclofenac topical solution) effective January 1, 2026. Coverage requires a diagnosis of knee osteoarthritis and approval lasts for the plan year duration.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflow for Pennsaid (diclofenac topical solution) prescriptions for Humana Medicare Advantage patients. Ensure providers document knee osteoarthritis diagnosis before prescribing. Update pharmacy prior auth system to flag these medications. Claims will be denied without proper prior authorization.