CommercialPrior AuthMedium impact
Coreg CR® (carvedilol ER) (Revised)
Humana·Cardiology, Internal Medicine, Family Medicine +1 more·Commercial
Effective date
May 22, 2024
We identified it
Jun 25, 2026
Summary
Humana revised its step therapy policy for Coreg CR® (carvedilol ER) effective May 22, 2024. The policy requires members to have prior treatment with at least two generic beta blockers (carvedilol tablet, atenolol tablet, or metoprolol tartrate/succinate) before Coreg CR coverage is approved. This is a step therapy requirement that affects pharmacy coverage for both brand-name Coreg CR and generic carvedilol phosphate ER.
Action Required
By May 22, 2024: Billing and pharmacy teams must implement step therapy verification for all Coreg CR® and carvedilol phosphate ER prescriptions on Humana Commercial plans. Before processing claims or prior authorization requests, verify that members have documented prior treatment with at least two of the following: carvedilol tablet, atenolol tablet, metoprolol tartrate, or metoprolol succinate. Update pharmacy management systems and prior authorization workflows to enforce this requirement. Communicate the requirement to providers and pharmacy staff. Prescriptions lacking evidence of prior beta blocker therapy will require denial or step therapy denial letters. Reference http://apps.humana.com/tad/tad_new/home.aspx to confirm this is the current version before processing any claims.