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CommercialPrior AuthHigh impact

Angiotensin Blocking & Renin Inhibitor Agents (Revised)

Humana·Cardiology, Family Medicine, Internal Medicine +2 more·Commercial
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Commercial plans now require step therapy for angiotensin blocking and renin inhibitor agents (ARBs/ACE inhibitors). Members must have tried and failed TWO of the preferred first-line medications before coverage approval for brand-name or higher-tier options like Atacand, Benicar, Diovan, and others.

Action Required

Action needed
Immediately: When prescribing angiotensin blocking or renin inhibitor agents for Humana Commercial patients, verify patient has documented trials of TWO preferred medications (lisinopril, ramipril, losartan, valsartan, etc.) before prescribing non-preferred options. Update prior authorization requests to include documentation of previous medication trials. Inform providers to document medication history and reasons for failure in medical records. Claims for non-preferred agents will be denied without proper step therapy documentation.