CommercialPrior AuthHigh impact
ADHD Long Acting Stimulants (Revised)
Humana·Family Medicine, Pediatrics, Psychiatry +2 more·Commercial
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has revised their ADHD Long Acting Stimulants step therapy policy for commercial plans, requiring patients to try at least two specific generic first-line medications before accessing other ADHD stimulant medications. The policy implements automatic approval for patients who have previously failed, had intolerance, or contraindications to the required first-line treatments.
Action Required
Immediately: Billing and clinical staff must implement step therapy verification for all ADHD long-acting stimulant prescriptions for Humana commercial patients. Before prescribing non-preferred ADHD medications, verify patient has tried at least two of the required first-line medications (atomoxetine, generic Adderall XR, methamphetamine, generic Concerta 18/27/36/54mg, generic Metadate ER 10/20mg, dexmethylphenidate ER, generic Vyvanse, or Dyanavel XR). Document previous treatments, intolerances, or contraindications in patient records. Update prior authorization request workflows to include this step therapy documentation. Claims may be denied without proper step therapy compliance.