Medicare AdvantagePrior AuthMedium impact
Loreev XR® (lorazepam) (Revised)
Humana·Psychiatry, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Feb 25, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for Loreev XR® (lorazepam extended-release capsules), effective February 25, 2026. The policy requires prior authorization for this medication with strict enrollment criteria: patient must have anxiety disorder diagnosis per DSM-5, prior treatment failure/intolerance to SSRIs/SNRIs/buspirone, prior treatment with generic lorazepam tablets, and current stable three-times-daily dosing with generic lorazepam. Initial and renewal approvals are limited to six-month periods.
Action Required
By February 25, 2026: Billing and clinical staff must implement prior authorization requirements for all Loreev XR® prescriptions on Humana Medicare Advantage plans. (1) Update billing system to flag Loreev XR® claims as requiring prior authorization before submission. (2) Providers must verify the four approval criteria are met before prescribing: DSM-5 anxiety diagnosis confirmation, documented prior treatment failure/contraindication/intolerance to SSRI/SNRI/buspiron, prior generic lorazepam tablet treatment history, and current stable three-times-daily generic lorazepam dosing. (3) Create pre-authorization documentation checklist in EMR to capture these criteria at point of care. (4) Set claim submission workflow to require PA approval before processing. (5) Note that approvals are limited to 6-month periods for both initial and renewal; set internal reminders for renewal requests 30 days before expiration. Failure to obtain prior authorization will result in claim denials for Medicare Advantage members.