Specialty Pharmacy Drug List update

Effective for dates of service beginning on Oct. 1, 2021, we’re adding the following specialty medications to our Specialty Pharmacy Requirements Drug List for UnitedHealthcare commercial plans.

The full Specialty Pharmacy Requirements Drug List, including the commercial plans that are excluded from the requirement, can be found here.

Code list update

We will announce the pharmacy information for Nulibry™ prior to Oct. 1, 2021.

Specialty pharmacy requirement

Outpatient hospitals are required to obtain the medications listed above from the indicated specialty pharmacies for administration of these medications, unless otherwise authorized by us. When the specialty medication is obtained through the specialty pharmacy, the specialty pharmacy will bill us directly under the member’s medical benefit.

Questions? Please contact your Network Management or Provider Relations teams.

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