UnitedHealthcare (UHC) and OptumRx recently made changes that may affect coverage or reimbursement process of Genentech therapies.

8/5/2019

Good afternoon,


As you may know, UnitedHealthcare (UHC) and OptumRx recently made changes that may affect coverage or reimbursement process of Genentech therapies.


Several fax numbers used for UHC Medical Prior Authorization requests will be retired. Go to:http://uhcprovider.com/faxfor more details.

· August 5, 2019 - UnitedHealthcare West

· September 3, 2019 – UnitedHealthcare Community Plan

· October 1, 2019 – UnitedHealthcare Commercial Plan


Several fax numbers used for OptumRx Pharmacy Prior Authorization requests will be retired. Go to: http://professionals.optumrx.com for more details.

· October 1, 2019 – OptumRx


Effective October 1, 2019, Optum will start managing Prior Authorization requests for certain injectable medications for certain UHC Commercial Plan members. You will need to use a new process to request Prior Authorization once the existing authorization expires or if you change the therapy. This new process will apply to the specialty medication listed under Injectable Medications section on the Enterprise Prior Authorization List, or a medication that is required by BriovaRX Specialty Pharmacy according to the UnitedHealthcare Administrative Guide.


For additional information, please refer to:

UHC July 2019 Network Bulletin

http://www.uhcprovider.com/orcall877-842-3210.



I am available to answer your questions regarding the new UHC policy and its implications. You can reach me at 916-225-7038


Best regards,


Bryan Hill

BioOncology Field Reimbursement Manager

Genentech



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