Please note the following regarding Medically-Accepted Indications
All reasonable efforts have been made to ensure consideration of medically accepted indications in this policy. Medically accepted indications are defined by CMS as those uses of a covered Part D drug that are approved under the federal Food, Drug, and Cosmetic Act, or the use of which is supported by one or more citations included or approved for inclusion in any of the compendia described in section 1927(g)(1)(B)(i) of the Act. These compendia guide review of off-label and off-evidence prescribing and are subject to minimum evidence standards for each compendium. Currently, this review includes the following references when applicable and may be subject to change per CMS:
- American Hospital Formulary Service (AHFS) Compendium
- Thomson Micromedex/DrugDex (not Drug Points) Compendium
- National Comprehensive Cancer Network (NCCN) Drugs and Biologics Compendium™
- Elsevier Gold Standard's Clinical Pharmacology Compendium
Request Submission
Doctors can submit their requests to the Humana Clinical Pharmacy Review (HCPR) through the following method.
Fax Requests
Complete the applicable form below and fax to 1-855-681-8650.
To obtain the status on a prior request or for general information, you may contact HCPR by calling 1-866-488-5991 Monday through Friday, 8:00 AM to 6:00 PM local time.
- Prescriber Quick Reference Guide
- This guide helps prescribers determine which Humana medication resource to contact for prior authorization, step therapy, quantity limits, medication exceptions, appeals, precertification and claims, along with applicable phone, fax or Web contact information.
- (0.5 MB) Download PDF
- English
