This pharmacy bulletin outlines new or revised clinical programs and implementation dates. It’s available online for UnitedHealthcare commercial and UnitedHealthcare Oxford commercial plans.
Medicare: Prior authorization required for oncology anti-emetics Effective Jan. 3, 2022, 4 anti-emetic drugs will require prior authorization for UnitedHealthcare Medicare Advantage members with a cancer diagnosis. This change is only for members of benefit plans requiring prior authorization for outpatient injectable chemotherapy. However, this change doesn’t affect outpatient injectable chemotherapy prior authorization requirements, only requirements for anti-emetic drugs.
New York: Update to injectable cancer therapy effective date In the July Network Bulletin, we published the New York: Injectable cancer therapy update with an effective date of Oct. 1, 2021. We’re delaying the announced transition of the prior authorization requests to Optum and the prior authorization requirements.
Kentucky: Prior authorization and site of service update
We previously announced an Oct. 1, 2021, implementation date for prior authorization and site of service reviews for commercial plans in Kentucky. Please note, we’re delaying the implementation date to Jan. 1, 2022, as outlined below.
New Jersey: 2022 referral update
Starting Nov. 17, 2021, UnitedHealthcare Community Plan of New Jersey is implementing a referral process for members who need specialty care.
Policy and protocol notices in 2022
Starting Jan 1, 2022, you will be able to find your policy and protocol updates from UnitedHealthcare under the policy and protocol updates category on UHCprovider.com/news.
Texas Medicaid: Prior authorization changes Effective Nov. 1, 2021, you’re required to submit a prior authorization when prescribing the attached drugs used to treat multiple sclerosis (MS) or high phosphate levels in Texas UnitedHealthcare Community Plan members.
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