CommercialPrior AuthMedium impact
Eysuvis™ (loteprednol etabonate) (Revised)
Humana·Ophthalmology, Optometry, Pharmacy·Commercial
Effective date
Jan 24, 2024
We identified it
Jun 25, 2026
Summary
Humana revised its Eysuvis (loteprednol etabonate) prior authorization policy effective January 24, 2024. The policy maintains prior authorization requirement for this ophthalmic corticosteroid suspension used to treat dry eye disease, with approval granted for plan year durations or through clinical review. The single approval criterion remains a diagnosis of dry eye disease.
Action Required
By January 24, 2024: Billing team and clinical staff must ensure Eysuvis (loteprednol etabonate) prescriptions for Humana commercial members require prior authorization before dispensing. Verify that pharmacy billing system flags all Eysuvis claims for PA requirement. Confirm that the approval criterion is limited to documented diagnosis of dry eye disease (keratoconjunctivitis sicca). Educate prescribing providers that this is short-term therapy (up to 2 weeks) and may be used as induction therapy. Update internal compliance documentation to reflect the January 24, 2024 revision date. Claims submitted without prior authorization will be denied. Reference current policy at http://apps.humana.com/tad/tad_new/home.aspx to confirm this remains the active version before processing claims.