Starting with dates of service on June 7, 2021, outpatient hospitals must obtain certain oncology supportive care medications from the participating specialty pharmacies we indicate, except as otherwise authorized by us.
This is an expansion of our existing “Requirement to Use a Participating Specialty Pharmacy Provider for Certain Medications,” as outlined in the UnitedHealthcare Administrative Guide.
This expanded requirement applies to UnitedHealthcare commercial plans including, but not limited to:
The requirement does not apply to:
UnitedHealthcare Oxford commercial plans are subject to the “Specialty Pharmacy Protocol for Certain Specialty Medications Administered in an Outpatient Hospital Setting.”
In the event the oncology supportive care medication is obtained through the specialty pharmacy we indicate:
We’ll announce the names and contact information for the indicated specialty pharmacies at a later date.
Questions? Please contact your Network Management or Provider Relations teams.