Medicare AdvantagePrior AuthMedium impact
Inbrija® (inhaled levodopa) (Revised)
Humana·Neurology, Pharmacy, Geriatrics·Medicare Advantage
Effective date
Jan 1, 2022
We identified it
Jun 25, 2026
Summary
Humana has revised its Inbrija® (inhaled levodopa) pharmacy coverage policy for Medicare Advantage plans, effective January 1, 2022, with the most recent revision dated January 28, 2026. The policy maintains prior authorization requirements for this medication, which is used to treat breakthrough 'off' episodes in Parkinson's disease patients already on carbidopa/levodopa therapy. Billing teams must verify all three coverage criteria are met before processing claims and ensure prior authorization is obtained before dispensing.
Action Required
By February 28, 2026 (30 days from revision): Billing and pharmacy teams must verify this is the current active policy version by checking Humana's online policy portal at www.humana.com/PAL. For all Inbrija® claims: (1) Verify the member has a Parkinson's disease diagnosis documented in the record; (2) Confirm the member is currently taking carbidopa/levodopa and will continue this concurrent therapy; (3) Document that the member is experiencing breakthrough 'off' periods; (4) Obtain prior authorization from Humana before dispensing. Update pharmacy dispensing systems to require prior auth flag for Inbrija® prescriptions. Train pharmacy staff on the three mandatory approval criteria. Note: Do not process claims for members taking nonselective MAO inhibitors, those with asthma/COPD/chronic lung disease, or those with major psychotic disorders without medical director review. Claims submitted without documented prior authorization will be denied.