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Medicare AdvantagePrior AuthMedium impact

Qelbree® (viloxazine) (Revised)

Humana·Psychiatry, Family Medicine, Pediatrics +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Qelbree (viloxazine) ADHD medication effective January 1, 2026. Patients must have tried and failed both stimulant medications AND atomoxetine before Qelbree will be approved.

Action Required

Action needed
By January 1, 2026: Providers must obtain prior authorization from Humana before prescribing Qelbree (viloxazine) for Medicare Advantage patients. Document patient's previous treatment failures with both stimulant medications (methylphenidate, dextroamphetamine-amphetamine) or non-stimulants (guanfacine ER, clonidine) AND atomoxetine. Update EMR templates to include ADHD medication history checklist. Claims will be denied without prior authorization.