UnitedHealthcare Updates Prior Authorization Requirements for Specialty Pharmacy Medications in Michigan

Michigan members of UnitedHealthcare Community Plan must request prior authorization or notification for all specific provider-administered medications that require it. Treatment changes have been deployed to cover a wide variety of therapies because they meet the medical necessity standards.

Affected Medications

The following medications will now require prior authorization:

NameDrug  HCPCS code
Briumvi J2329
Corticotropin® Gel J0802
Daxxify® J0589
Eylea HD J0177
Izervay J2782
Leqembi J0174
Panzyga® J1576
Pombiliti™ J1203
Qalsody J1304
Rystiggo J9333
Syfovre J2781
Tofidence™ Q5133
Tzield J9381
Veopoz J9376
Vyjuvek J3401
Vyvgart® Hytrulo™ J9334

 

How to Submit a Prior Authorization Request

Providers can submit prior authorization requests through the UnitedHealthcare website by following these steps:

  • Visit uhcprovider.com and sign in.
  • Select Prior Authorizations from the top menu.
  • Choose the option to create a new prior authorization submission from the available menu.
  • Select Specialty pharmacy from the dropdown menu.

 


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