Medicare AdvantagePrior AuthMedium impact
Cycloset® (bromocriptine) (Revised)
Humana·Endocrinology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2017
We identified it
Jun 25, 2026
Summary
Humana updated its Cycloset (bromocriptine) step therapy policy effective January 1, 2017, with a revision date of September 24, 2025. The policy clarifies that automatic approval is granted to Medicare Advantage members who have previous treatment with, contraindication to, or intolerance to metformin-containing medicines. Initial and renewal approvals are granted for plan year durations or as determined through clinical review. This is a step therapy policy requiring prior authorization for Cycloset in Medicare Advantage plans.
Action Required
Immediately: Billing team must implement step therapy prior authorization requirements for Cycloset (bromocriptine) tablets in Medicare Advantage plans. Update billing software and prior authorization submission processes to reflect automatic approval criteria: members with previous metformin treatment, contraindication to metformin, or documented intolerance to metformin-containing medicines. All other requests require clinical review. Ensure prior authorization is obtained before claims submission for Medicare Advantage members to avoid claim denials. Reference policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a4078cf for current version. Contact Humana via www.humana.com/PAL for preauthorization and notification list details.