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Medicare AdvantagePrior AuthMedium impact

Savella® (milnacipran) (Revised)

Humana·Rheumatology, Pain Management, Neurology +2 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Savella (milnacipran) for fibromyalgia treatment, effective January 1, 2025. Patients must have a fibromyalgia diagnosis and have tried or had contraindications to at least two specific medications (pregabalin, duloxetine, or gabapentin) before approval.

Action Required

Action needed
Immediately: Billing team must update systems to require prior authorization for all Savella (milnacipran) prescriptions for Humana Medicare Advantage patients. Providers must document fibromyalgia diagnosis and document previous treatment failure, contraindication, or intolerance to at least two of these medications: pregabalin, duloxetine, or gabapentin. Visit www.humana.com/PAL for preauthorization requests. Claims without prior authorization will be denied.