Medicare AdvantagePrior AuthMedium impact
Ibsrela® (tenapanor) (Revised)
Humana·Gastroenterology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Ibsrela (tenapanor) tablets for irritable bowel syndrome with constipation (IBS-C). Patients must have an IBS-C diagnosis and must have tried, been intolerant to, or have a contraindication to Linzess (linaclotide) first.
Action Required
Immediately: Billing team must update prior authorization protocols for Ibsrela (tenapanor) prescriptions. Verify patients have IBS-C diagnosis and previous treatment with/intolerance to Linzess before submitting prior auth requests. Providers must document these requirements in medical records. Claims will be denied without proper prior authorization.