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Medicare AdvantagePrior AuthHigh impact

Provider News - June 2017

Security Health Plan·WI·Provider News
Effective date
Nov 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Security Health Plan is implementing a new medical pharmacy management service through Magellan Rx effective November 1, 2017, which will require prior authorization for specialty medications administered in medical settings (medical pharmacy benefits). The policy also provides updated colorectal cancer screening coverage details across different plan types.

Action Required

Action needed
Before November 1, 2017: Billing and clinical staff must prepare for new prior authorization requirements for specialty medications administered in medical settings through Magellan Rx. Watch for detailed implementation communications from Security Health Plan via Provider News, provider portal, and onsite trainings. Update workflows to incorporate prior authorization process for medical pharmacy benefits to avoid claim denials.