Update: Prior authorization process effective date changed from Oct. 3, 2022 to Dec. 1, 2022
Last modified: Nov. 17, 2022
Effective Dec. 1, 2022, you can submit chemotherapeutic prior authorization requests using the Medical Benefit Management (MBMNow) tool for your patients who have pharmacy benefits through OptumRx. This applies to members with UnitedHealthcare commercial and Individual Exchange plans.¹ You’ll no longer need to submit these prior authorization requests to OptumRx.
With this new process, you can manage your prior authorization requests for oncology medications using the same process as infused chemotherapies.
Affected plans | Non-affected health plans |
---|---|
Individual Exchange plans (all states) | Golden Rule |
Commercial plans | Student Resource |
All Savers | Sierra/Health Plan of Nevada |
Neighborhood Health Plan | UHC International |
River Valley | UHC West |
Oxford |
If a new prior authorization is needed on or after Dec. 1, 2022, submit a prior authorization request:
Coverage determinations won’t change due to this new prior authorization request process.
If you already have prior authorization approval for a member’s treatment plan, you don’t need to submit a new request.
If you have questions, please email cancerauthorizationprogram@optum.com.