Medicare AdvantagePrior AuthMedium impact
Bysanti™ (milsaperidone) (New)
Humana·Psychiatry, Family Medicine, Internal Medicine·Medicare Advantage
Effective date
Jun 24, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage is implementing new prior authorization requirements for Bysanti (milsaperidone), a new atypical antipsychotic medication used to treat schizophrenia and bipolar I disorder. Prior auth will require documentation of diagnosis and trial/failure of at least 2 specific alternative medications before approval.
Action Required
By June 24, 2026: Providers treating schizophrenia or bipolar I disorder must obtain prior authorization before prescribing Bysanti (milsaperidone) for Humana Medicare Advantage patients. Document patient's diagnosis and previous trials or contraindications to at least 2 required alternative medications (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, or lurasidone for schizophrenia; exclude lurasidone for bipolar). Update EMR templates to capture this information. Prescriptions without prior auth will be denied.