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Medicare AdvantagePrior AuthLow impact

Rhopressa® (netarsudil), Rocklatan® (netarsudil and latanoprost) (Revised)

Humana·Ophthalmology, Optometry·Medicare Advantage
Effective date
May 27, 2026
We identified it
Jun 25, 2026
Days to comply

Summary

Humana Medicare Advantage has revised its pharmacy coverage policy for Rhopressa (netarsudil) and Rocklatan (netarsudil/latanoprost) eye drops, maintaining step therapy requirements. Coverage now requires documented evidence that the patient has had previous treatment, contraindication, or intolerance to a prostaglandin analog before approval. This is a routine policy revision with no material changes to coverage criteria.

Action Required

Action needed
Before May 27, 2026: Billing and prior authorization teams should verify this policy revision in Humana's system to ensure current step therapy requirements are enforced. When processing claims or prior auth requests for Rhopressa or Rocklatan for Medicare Advantage members, confirm that providers document prior prostaglandin analog treatment, contraindication, or intolerance in the clinical justification. No immediate action required if your practice already obtains this documentation for these medications; however, review existing standing orders or protocols to ensure compliance with the step therapy requirement.