Medicare AdvantagePrior AuthMedium impact
Gocovri® (amantadine extended release) (Revised)
Humana·Neurology, Internal Medicine, Geriatrics·Medicare Advantage
Effective date
Jan 1, 2022
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has revised its Gocovri (amantadine extended-release) prior authorization policy effective January 1, 2022, with updates as of November 26, 2025. The policy requires prior authorization for two indications: levodopa-induced dyskinesia in Parkinson's disease (requiring failed trial of immediate-release amantadine) and Parkinson's disease 'off' episodes (requiring prior treatment with or contraindication to at least two specific medication classes). Billing teams must verify that all Gocovri prescriptions meet these criteria before processing claims.
Action Required
Immediately: Billing team must implement prior authorization review process for all Gocovri (amantadine extended-release) claims under Medicare Advantage plans. For levodopa-induced dyskinesia claims, verify documentation shows: (1) Parkinson's disease diagnosis with dyskinesia, (2) current levodopa-based therapy, and (3) documented inadequate response to immediate-release amantadine. For 'off' episodes claims, verify: (1) Parkinson's disease diagnosis, (2) current carbidopa/levodopa use, (3) active 'off' episodes, and (4) previous treatment with or documented contraindication/intolerance to at least TWO of the following: dopamine agonist, MAO-B inhibitor, or COMT inhibitor. Do NOT process claims lacking this documentation. Update intake forms and provider submission templates to require this clinical evidence. Flag for providers any incomplete prior authorization requests before submission. Failure to obtain prior authorization will result in claim denials.