Chemotherapy was previously added to Humana's Commercial and Medicare Advantage preauthorization and notification lists. Humana is expanding its Oncology Quality Management Program into additional markets, affecting its commercial and Medicare Advantage products for 2014. Humana's Oncology Quality Management Program, administered by New Century Health or Oncology Analytics, includes preauthorization management for chemotherapeutic drugs, symptom management drugs and supportive agents. Affected providers will be contacted prior to the effective date below by their appointed vendor.
Beginning January 18, 2014, or upon completion of vendor systems and education training (whichever comes first), the Oncology Quality Management Program will become effective in the following markets: Texas, Washington, Oregon, Idaho, Iowa, Nevada, California, Utah, New Mexico, Oklahoma, Arkansas, New Hampshire, Wyoming, Montana, South Dakota, North Dakota, Nebraska, Massachusetts, Pennsylvania, New York, Connecticut, Maine, Delaware, Rhode Island, Mississippi, Alabama, Maryland, New Jersey, Vermont, Alaska and Hawaii. The Oncology Quality Management Program is already effective for Humana's Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Kansas City (Kansas/Missouri), Michigan, Minnesota, North Carolina, South Carolina, Ohio, Kentucky, Louisiana, Tennessee, Virginia, West Virginia and Wisconsin commercial and MA plans.
For markets assigned to New Century Health, choose one from the following options to submit the chemotherapy treatment request (CTR) form:
- Initiate an online preauthorization request for an affected drug by logging in to New Century Health's website at my.newcenturyhealth.com. Enter your username and password.
- Fax the completed CTR form to New Century Health at 1-877-624-0611.
- Contact New Century Health's pharmacy intake department at 1-855-427-1372, option 5, 8 a.m. to 8 p.m. Eastern time, Monday through Friday.
Questions about Humana's Oncology Quality Management Program may be directed to New Century Health at 1-855-427-1372, option 5.
For markets assigned to Oncology Analytics, choose one from the following options to submit the CTR form:
- Initiate an online preauthorization request for an affected drug by logging in to Oncology Analytics' website at www.oncologyanalytics.com. Choose "Provider Login" at the top of the screen. Please note: physicians must first call 1-888-916-2616 to obtain a username and password.
- Fax the completed CTR form to Oncology Analytics at 954-622-2431.
- Contact Oncology Analytics' utilization management department at 1-888-916-2616, 9 a.m. to 5 p.m. Eastern time, Monday through Friday. Physicians may contact an Oncology Analytics medical director from 8 a.m. to 8 p. m. Eastern time, Monday through Friday. The phone number of the on-call physician can be found by calling 1-888-916-2616.
Keep in mind that preauthorization requests for drugs for noncancer diagnoses that are listed on Humana's preauthorization and notification lists must be directed to Humana's Medication Intake Team (MIT). Medication preauthorization requests may be faxed to MIT at 1-888-447-3430.
For reauthorization of previously approved chemotherapeutic drugs:
- Authorizations previously issued by Humana before the applicable effective date will be effective until the authorization expiration date.
- New authorization requests must be submitted to New Century Health or Oncology Analytics on or after the applicable implementation date.