Effective January 1, 2022 UnitedHealthcare Community Plan of Minnesota will manage both Families and Children (also known as Prepaid Medical Assistance Program) and MinnesotaCare members in the following seven counties in Minnesota: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington.
Pharmacy Billing Information:
Find pharmacy information related to prescription drugs including prescription drug lists, step therapy, quantity limits and prior authorization requirements for Community Plan care providers.
In response to the U.S. opioid epidemic, UnitedHealthcare has developed programs to help our members receive the care and treatment they need safely and effectively.
We’ve also established measures based on the Centers for Disease Control and Prevention’s (CDC) opioid treatment guidelines to help prevent overuse of short-acting and long-acting opioid medications.
Resources from UnitedHealthcare and Optum
The PreCheck MyScript Solution on Link helps make it easy to run a pharmacy trial claim and get real-time prescription coverage detail for your patients who are UnitedHealthcare benefit plan members.
CoverMyMeds streamlines the medication prior authorization process, electronically connecting providers, pharmacists and plan/PBMs to improve time to therapy and decrease prescription abandonment with electronic prior authorization.
Specialty pharmacy medications covered under the member’s medical benefit may be provided through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.
If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through a network specialty pharmacy.
Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.
Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.
Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.
UnitedHealthcare’s Medication Therapy Management (MTM) program is a free service for eligible members to enhance their medication treatment plan. This program allows certified pharmacists to provide members with medication review to address drug therapy related problems or issues.
For more information related to the Medication Therapy Management (MTM) program, please visit the UHC Community Plan Care Providers Manual (Minnesota) or Medication Therapy Management Services (MTMS) (state.mn.us)
Send an email request to email@example.com and include the following information: care provider full name, tax ID, service address location(s), and National Provider Identifier (NPI).
For additional questions about contracting with the Minnesota Community plan you may contact firstname.lastname@example.org.