All PlansAdministrativeMedium impact
Provider News - December 2025
Security Health Plan·WI·Provider News
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Security Health Plan's December 2025 provider newsletter highlights several key updates including a transition to Optum Rx as their pharmacy benefit manager effective January 1, 2026, and emphasizes the requirement to use their Provider Portal for all prior authorization submissions. The newsletter also reinforces year-end HCC coding focus areas and various administrative reminders for providers.
Action Required
By January 1, 2026: Update pharmacy benefit processes to work with Optum Rx as Security Health Plan's new PBM. Immediately: Ensure all prior authorization requests are submitted through Security Health Plan's Provider Portal rather than fax or phone. Billing team should verify current HCC coding accuracy for chronic kidney disease, diabetes mellitus, and heart failure for year-end 2025 capture.