Home Forums Payer Issues UHC New Policy

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  • #5922
    Jennifer Vogel
    Participant

    I’d like to share a forum update presented by Jay Salliotte, the current NORM President.

    I wanted to share a post by Jay Salliotte, the new NORM President:

    Hi NORM Nation- Several board members are receiving news of a major policy switch regarding UHC and IV Biologics from industry partners. The consistent interpretation we hear is the new policies published today are pushing patients toward the self-administered form of a biologic when there is an equivalent IV/in-office injection form of the drug. Specifically, they have updated their policies to reflect this change on Actemra, Benlysta, Cimzia, Orencia, Simponi and Stelara. (link below) The NORM Advocacy & Healthcare Policy team is reaching out to UHC representatives to confirm these policy changes. We also want to know how this affects patients who have a valid authorization in place for an IV product. What is most shocking is these changed are effective TODAY, OCT 1, 2019! There was no advanced notice. We will update you with answers as we receive them. NORM will also update you on how to fight this policy change (once we get our bearings). The individual policies are accessible here: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/mpub-archives/commercial/medical-policy-update-bulletin-october-2019.pdf

    #5923
    Jennifer Vogel
    Participant

    Sorry everyone. This was supposed to be on the Community Forum for Biologic Coordinators.

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