CommercialPrior AuthMedium impact
Neupro® (rotigotine) (Revised)
Humana·Neurology, Sleep Medicine·Commercial
Effective date
Jan 24, 2024
We identified it
Jun 25, 2026
Summary
This is a revised Humana Commercial prior authorization policy for Neupro® (rotigotine) transdermal patches, effective January 24, 2024. The policy maintains prior authorization requirements for two indications: Parkinson's Disease (requires diagnosis plus prior treatment/contraindication/intolerance to ropinirole and pramipexole OR diagnosis of dysphagia) and Restless Legs Syndrome (requires moderate-to-severe primary RLS diagnosis plus prior treatment/contraindication/intolerance to ropinirole and pramipexole). Approval duration is for the initial plan year.
Action Required
By January 24, 2024: Billing team must ensure prior authorization processes are in place for all Neupro® (rotigotine) transdermal patch claims submitted under Humana Commercial plans. Verify that clinical staff or prior authorization personnel have access to the current policy at http://apps.humana.com/tad/tad_new/home.aspx before processing any claims. When submitting prior authorization requests, ensure documentation includes: (1) confirmed diagnosis of either Parkinson's Disease or moderate-to-severe primary Restless Legs Syndrome, and (2) evidence of prior treatment with, contraindication to, or documented intolerance to ropinirole and pramipexole (OR for PD patients only: documentation of dysphagia/swallowing difficulty). Update internal prior authorization templates and checklists to reflect these specific criteria. For medically billed requests, staff should reference www.humana.com/PAL for applicable preauthorization and notification lists. Claims submitted without proper prior authorization or incomplete medical justification will be denied.