Medicare AdvantagePrior AuthMedium impact
Cycloset® (bromocriptine) (Revised)
Humana·Endocrinology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
We identified it
Jul 22, 2026
Summary
Humana Medicare Advantage has implemented a Step Therapy policy for Cycloset® (bromocriptine), requiring members to try alternative treatments before accessing this medication. This is a coverage/access requirement that will impact prescription authorizations for diabetic patients. The billing team must ensure prior authorization workflows are updated to enforce step therapy requirements.
Action Required
Immediately: Billing and clinical staff must implement step therapy verification for all Cycloset® (bromocriptine) prescription requests for Humana Medicare Advantage members. (1) Update prior authorization submission processes to require documentation that member has failed or is contraindicated to first-line diabetes therapies before Cycloset® will be approved. (2) Train billing team to flag Cycloset® requests for step therapy review before submitting to Humana. (3) Communicate new requirement to prescribing providers via updated clinical guidelines or EMR alerts. (4) Update patient eligibility/benefits tools to reflect step therapy requirement. Failure to obtain step therapy approval will result in claim denials and delays in medication access for members.