MedicaidPrior AuthMedium impact
Anticholinergic Polypharmacy Agents - Louisiana Medicaid (New)
Humana·LA · Geriatrics, Family Medicine, Internal Medicine +1 more·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid is implementing a new safety edit requiring prior authorization for concurrent use of two or more anticholinergic medications in members 65+ or in hospice. Approval requires provider attestation that benefits outweigh risks of falls, cognitive decline, and delirium per Beers Criteria.
Action Required
Before October 1, 2025: Billing and clinical staff must identify Louisiana Medicaid members 65+ or in hospice taking multiple anticholinergic medications (antihistamines, antiparkinson drugs, muscle relaxants, TCAs, paroxetine, antipsychotics, antimuscarinics, antispasmodics, antiemetics). Providers must obtain prior authorization by attesting that benefits outweigh risks and providing patient education. Update billing system to flag these combinations. Claims may be denied without proper authorization.