Medicare AdvantagePrior AuthMedium impact
Onapgo® (apomorphine) (Revised)
Humana·Neurology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
May 28, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Onapgo (apomorphine) subcutaneous cartridge for advanced Parkinson's disease treatment. Patients must meet four specific criteria including diagnosis confirmation, persistent motor fluctuations despite optimized therapy, and trial of other anti-Parkinson agents.
Action Required
Before May 28, 2025: Billing team must update prior authorization workflow for Onapgo (apomorphine) subcutaneous cartridge for Humana Medicare Advantage patients. Providers must document: (1) advanced Parkinson's disease diagnosis, (2) persistent motor fluctuations despite optimized carbidopa/levodopa therapy, (3) trial or contraindication to COMT inhibitor, MAO-B inhibitor, dopamine agonists, or amantadine, and (4) complete BvsD Coverage Determination if required. Claims will be denied without proper prior authorization.