All PlansPrior AuthMedium impact
Mutual News Q2 2019 Newsletter
Medical Mutual of Ohio·OH·Mutual News Newsletter
Effective date
Apr 1, 2019
We identified it
Jun 20, 2026
Summary
Medical Mutual's Q2 2019 newsletter outlines multiple corporate medical policy updates and pharmacy policy changes that occurred between January 1 and March 31, 2019. Several new policies were added (including Prostatic Urethral Lift and various specialty medications), many existing policies were revised, and 15 pharmacy policies were retired as the drugs no longer require prior authorizations as of April 1, 2019.
Action Required
Review the complete list of updated Corporate Medical Policies at Provider.MedMutual.com > Tools & Resources > Care Management > Corporate Medical Policies. Update prior authorization workflows to reflect that 15 specific medications (including Cyclophosphamide, Dacogen, Gemzar, and others listed) no longer require prior authorization as of April 1, 2019. Ensure behavioral health discharge planning includes scheduling follow-up appointments within 7 days and coordination between PCPs and behavioral health providers.