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Medicare AdvantagePrior AuthMedium impact

Motegrity® (prucalopride) (Revised)

Humana·Gastroenterology, Family Medicine, General Practice +1 more·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Motegrity (prucalopride) for chronic idiopathic constipation, with mandatory documentation that patients have failed or cannot tolerate Linzess and lubiprostone first. This creates a new step-therapy requirement for this constipation medication.

Action Required

Action needed
Immediately: Providers must obtain prior authorization from Humana Medicare Advantage before prescribing Motegrity (prucalopride). Document patient's diagnosis of chronic idiopathic constipation and previous treatment failure, intolerance, or contraindication to Linzess (linaclotide) and lubiprostone. Add prior auth reminder to EMR templates for constipation treatments. Claims will be denied without proper authorization.