United Healthcare: New Requirement for Inflammatory Medications

Effective Oct. 1, 2015, UHC will require prior authorization for administering certain specialty medications for inflammatory conditions in hospital outpatient facilities.

Actemra®            Entyvio®              Orencia®             Remicade®         Simponi Aria®

The new requirement applies to both new and current UnitedHealthcare commercial plans, Mid-Atlantic, Oxford, NHP and River Valley members. It may require members to switch to an alternate site of service when there is a clinically appropriate more cost-effective option available.



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The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.