Medicare AdvantagePrior AuthMedium impact
Invega® (paliperidone extended release) (Revised)
Humana·Psychiatry, Neurology, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage revised prior authorization criteria for Invega (paliperidone extended release) effective January 1, 2025. The policy requires documentation of prior therapy failure or contraindication to at least 2 specific alternative antipsychotics before approving Invega for schizophrenia, schizoaffective disorder, and bipolar disorder.
Action Required
Immediately: Providers treating patients with schizophrenia, schizoaffective disorder, or bipolar disorder must document prior therapy failure, intolerance, or contraindication to at least 2 specified alternative antipsychotics (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, or lurasidone) before prescribing Invega. Update EMR templates to include this documentation requirement. Billing team must ensure prior authorization is obtained for all Invega prescriptions or claims will be denied.