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Learn more about research and trends that impact your practice.

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Prior authorization submission information

Professionally administered drugs prior authorization

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Prior authorization for professionally administered drugs 

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Clinical practice guidelines

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Humana periodically monitors compliance with nationally recognized clinical practice guidelines.

*Humana publishes medical guidelines from a number of well-respected national sources. These guidelines may have some differences in recommendations. Information contained in the guidelines is not a substitute for a physician’s or other healthcare professional's clinical judgment and is not always applicable to an individual. Therefore, the physician or healthcare professional and patient should work in partnership in the decision-making process regarding the patient's treatment. Furthermore, using this information will not guarantee a specific outcome for each patient. None of the information in the guidelines is intended to interfere with or prohibit clinical decisions made by a treating physician or other healthcare professional regarding medically available treatment options for patients.

Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage to determine benefits.

Links to other websites are provided for your convenience only and do not constitute or imply endorsement by Humana of these sites, products or services described on these sites, or of any other material contained therein. Humana disclaims responsibility for their content and accuracy.

Guidelines adopted by Humana

Anxiety

Attention deficit/hyperactivity disorder

Children with autism spectrum disorder

Back pain

Behavior or conduct problems in children

Bipolar disorder in adults

Cardiovascular

Cholesterol treatment

COVID-19

Depression

Diabetes

Fall prevention

Headache/migraine

Human Immunodeficiency Virus (HIV)

Hypertension

Immunizations

Incontinence urinary

Kidney disease

Obsessive Compulsive Disorders (OCDs)

Opioids

Oxygen therapy

Palliative care

Post-traumatic stress disorder

Pregnancy

Preventive services

Respiratory

Schizophrenia

Sickle cell anemia

Sleep apnea

Sleep/insomnia

Substance use disorders

Suicide

Syphilis (including congenital syphilis)

Telehealth

Transgender

Patient care