Chronic myeloid leukemia, prostate, esophageal and gastric
As of Feb. 1, 2023, chronic myeloid leukemia (CML), prostate, esophageal and gastric will be added to our Cancer Therapy Pathways Program.
The Cancer Therapy Pathways Program is designed to enhance quality and value in cancer care and offer rewards when you treat patients using therapies associated with better clinical outcomes. Cancer Therapy Pathways are detailed, evidence-based regimens selected through rigorous evaluation for specific cancer types and stages.
Participate in the Cancer Therapy Pathways Program
Health care professionals in all states are eligible to use the UnitedHealthcare Cancer Therapy Pathways. To participate, you must submit prior authorization requests for chemotherapy or related therapies through Optum’s Cancer Guidance Program for patients who are UnitedHealthcare Community Plan, commercial or Medicare plan members.
To participate, simply start a new prior authorization request and select the appropriate regimen. You can track your participation in the Optum dashboard available through Optum’s Cancer Guidance Program online portal on the UnitedHealthcare Provider Portal at UHCprovider.com > Sign In.
You may earn rewards for using UnitedHealthcare Cancer Therapy Pathways if:
You’re in network for your patient’s benefit plan
Your patient is part of a UnitedHealthcare commercial plan eligible for rewards*
You may receive** a $1,000 cash payment for each pathway regimen selected when:
Pathway adherence is at least 75% over a 6-month period
The minimum 5 authorizations are met during 6-month measurement period (January–June, July–December)
*Excludes Hawaii, North Carolina, Puerto Rico and the U.S. Virgin Islands. Contract amendment required to receive program rewards in California, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, Virginia, Washington and West Virginia.
**Subject to all applicable program requirements, terms and conditions