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.
You can learn more about the submission process in our online training.
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.