CommercialPrior AuthLow impact
Dronabinol (GENERIC) (Revised)
Humana·Oncology, Infectious Disease, Internal Medicine·Commercial
Effective date
Aug 28, 2024
We identified it
Jun 25, 2026
Summary
Humana revised its Dronabinol (generic) prior authorization policy effective August 28, 2024. The policy maintains existing requirements for two indications: AIDS-related anorexia (requires trial/intolerance/contraindication to megestrol acetate) and chemotherapy-induced nausea/vomiting (requires trial/intolerance/contraindication to at least two other antiemetic agents). No substantive coverage criteria changes are documented; this appears to be a routine policy refresh/review.
Action Required
By September 30, 2024: Billing team should verify that the Humana system reflects the August 28, 2024 revision date for Dronabinol prior authorization requests. Confirm that prior authorization processes require documented evidence of: (1) for AIDS patients—trial, intolerance, or contraindication to megestrol acetate oral suspension, and (2) for chemotherapy patients—trial, intolerance, or contraindication to at least two other antiemetic agents (e.g., ondansetron, prochlorperazine). No claim submission workflow changes are required unless your practice previously had different requirements. Providers should note that claims without proper prior authorization documentation will be denied. Reference the current policy at http://apps.humana.com/tad/tad_new/home.aspx before processing requests.