MedicaidPrior AuthMedium impact
Duopa® (carbidopa and levodopa) (Revised)
Humana·IN · Neurology, Pharmacy·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has updated the prior authorization policy for Duopa (carbidopa/levodopa enteral suspension) for Indiana Medicaid patients with advanced Parkinson's disease. The policy requires members to meet four specific criteria including having a diagnosis of advanced PD, experiencing persistent motor fluctuations despite optimized therapy, having tried other anti-Parkinson agents, and having a gastro-jejunostomy tube for delivery.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Duopa prescriptions for Indiana Medicaid patients. Verify patients meet all four criteria: advanced Parkinson's diagnosis, persistent motor fluctuations despite optimized carbidopa/levodopa therapy, trial of other anti-Parkinson agents (COMT inhibitor, MAO-B inhibitor, dopamine agonists, or amantadine), and presence of PEG-J tube with CADD-Legacy 1400 pump. Update pharmacy prior authorization workflows to include these requirements. Claims will be denied without proper prior authorization.