The Humana Oncology Quality Management Program, founded on evidence-based care standards, uses a counseling model within traditional preauthorization management for chemotherapeutic drugs, symptom management drugs and supporting agents.
This program is administered by New Century Health for patients with Humana commercial and Medicare Advantage plans and some Administrative Services Only members in the following states:
- Florida (only in the following counties: Alachua, Baker, Bay, Bradford, Calhoun, Charlotte, Citrus, Clay, Collier, Columbia, Dade, DeSoto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Gulf, Hamilton, Hardee, Hernando, Highlands, Hillsborough, Holmes, Jackson, Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Miami, Nassau, Okaloosa, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, St. Johns, Santa Rosa, Sarasota, Seminole, Sumter, Suwannee, Taylor, Union, Volusia, Wakulla, Walton and Washington)
- Illinois (including dual Medicare-Medicaid)
- Kentucky (including Medicaid)
- New Mexico
- North Carolina
- North Dakota
- South Carolina
- South Dakota
- West Virginia
All remaining preauthorization requirements remain in effect. The terms prior authorization, precertification, preadmission and preauthorization all refer to the preauthorization process.
New Century Health does not review preauthorization requests from healthcare providers who participate in an independent practice association (IPA) or other risk network with delegated services. These healthcare providers should refer to their IPA or risk network for guidance on processing preauthorization requests.
Submitting preauthorization requests
Choose from the following options to submit a request for preauthorization:
- Log on to New Century Health’s website at
my.newcenturyhealth.com. Enter your username and password, then submit your request. If you need a username and password, call New Century Health at 855-427-1372, option 1, Monday – Friday, 8 a.m. – 8 p.m., Eastern time.
- Call New Century Health’s intake coordinator department at 855-427-1372, option 1, Monday – Friday, 8 a.m. – 8 p.m., Eastern time.
- To fax, choose the standard or relevant state-specific form from the Important Links box on the top right. Fill out the form and fax it to 877-624-0611.
If you have questions about this program, call 855-427-1372, option 1, Monday – Friday, 8 a.m. – 8 p.m., Eastern time.
Preauthorization and notification lists
View documents that list services and medications for which preauthorization may be required for patients with Humana Medicaid, Medicare Advantage, dual Medicare-Medicaid and commercial coverage.