Effective Jan. 3, 2022, Optum, an affiliate of UnitedHealthcare, will manage prior authorization requests for non-oncology Part B medications that are covered under a UnitedHealthcare Medicare Advantage plan’s medical benefit.
This won’t change the prior authorization request process for oncology-related medications.
The new process
You’ll continue to submit your requests for Medicare Part B medications online. You can find the medications requiring prior authorization in the Medicare Advantage Prior Authorization List and in the Medicare Part B Step Therapy Program policy.
To support our review, inclusive of a timely decision, clinical requirements will be documented within the request submission. You can also attach medical records, if requested.
To submit your requests:
What this means for existing authorizations
Authorizations active before Jan. 3, 2022, will remain in effect. You’ll see the new process when you request a prior authorization starting Jan. 3, 2022.
You won’t need to submit a new request until the existing authorization expires or you change the therapy. Changes in therapy include:
If you can’t find what you need on UHCprovider.com, please call Optum at 888-397-8129, 8 a.m.–5 p.m. local time, Monday–Friday, for information about the new process.