Medicare AdvantagePrior AuthMedium impact
Inhaled Anticholinergics (Revised)
Humana·Pulmonology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for inhaled anticholinergic medications (Yupelri, Tudorza Pressair, Incruse Ellipta, Atrovent HFA, and generic ipratropium/umeclidinium inhalers) for COPD treatment. Patients must have tried or be contraindicated to Spiriva first before these alternatives will be covered.
Action Required
By January 1, 2025: Providers must obtain prior authorization for Yupelri, Tudorza Pressair, Incruse Ellipta, Atrovent HFA, ipratropium bromide HFA, and umeclidinium inhalers for Humana Medicare Advantage patients. Document COPD diagnosis and previous treatment/contraindication to Spiriva. Update EMR templates to include prior auth requirements. Claims will be denied without proper authorization.