Kansas: new outpatient injectable drug requirements

We’re making updates to our requirements for certain injectable drugs billed on the medical benefit for UnitedHealthcare Community Plan of Kansas members. These requirements will apply whether members are new to therapy or have already been receiving these medications.

Effective June 1, 2021, prior authorization will be required for the following drugs for UnitedHealthcare Community Plan of Kansas members:

  • Abilify Maintena
  • Adasuve
  • Aristada
  • Aristada Initio
  • Bavencio
  • Benlysta
  • Blincyto
  • Chlorpromazine
  • Cinvanti
  • Darzalex
  • Emend (fosaprepitant)
  • Fabrazyme
  • Fluphenazine Decanoate
  • Glassia
  • Haloperidol Decanoate
  • Invega Sustenna
  • Jivi
  • Kyprolis
  • Lucentis
  • Mozobil
  • Perseris
  • Prolia
  • Remodulin (treprostinil)
  • Risperdal Consta
  • Tecentriq
  • Testosterone Enanthate
  • Truxima
  • Tysabri
  • Tyvaso
  • Xgeva
  • Xiaflex
  • Zinplava
  • Zyprexa (olanzapine)
  • Zyprexa Relprevv

If you administer any of these medications without first completing the prior authorization process, the claim may be denied. Members can’t be billed for services denied due to failure to complete the prior authorization process.

You can submit prior authorization requests:

  • Online: Use the Prior Authorization and Notification tool on Link through UHCprovider.com
  • Call: Use the Provider Services phone number on the member’s health care identification card