ConnectiCare has contracted with Magellan Rx Management (Magellan Rx) to manage the review of preauthorization requests for the following specialty drugs:
- Intravenous Immunoglobulin (IVIG)
- Subcutaneous Immunoglobulin (SCIG)
- Remicade® (infliximab)
- All Remicade’s biosimilar products
This is effective Jan. 1, 2018, for all our Medicare Advantage and commercial plans, including individual and group plans purchased through the state insurance exchange, Access Health CT.
Magellan Rx, the pharmacy benefit management division of Magellan Healthcare, has more than 12 years of experience in specialty pharmacy and medical drug benefit management, and has clinical pharmacists and physicians available to ConnectiCare providers as resources.
If you have any commercial or Medicare patients who are scheduled on or after Jan. 1, 2018, to receive any of the drugs listed above, you must obtain preauthorization for those treatments from Magellan Rx. Please note that through this preauthorization program, Magellan Rx may also direct commercial members to an alternative site of service, when appropriate.
To make sure your patients’ treatments continue without interruption, you can start submitting preauthorization requests to Magellan Rx starting Dec. 26, 2017. You can submit:
- Routine requests through Magellan Rx’s secure website at ih.MagellanRx.com (registration and log in required).
- Urgent requests by calling Magellan Rx at 1-800-424-8323 from 8 a.m. to 6 p.m. (ET) Monday through Friday.
If providers do not obtain preauthorization for IVIG, SCIG, Remicade or all Remicade’s biosimilar products from Magellan Rx after Jan. 1, 2018, claims may be denied.
Claims and appeals processes are not changing: please continue to submit claims, claims questions and appeals to ConnectiCare.
Magellan Rx will conduct web-based training sessions in December so they can review the details of the program and how to properly submit preauthorization requests. The 30-minute sessions will be held at the following dates and times:
- Dec. 21, 2017, Thursday, 8 a.m. ET
- Dec. 21, 2017, Thursday, noon ET
- Dec. 28, 2017, Thursday, 9 a.m. ET
- Dec. 28, 2017, Thursday, 1 p.m. ET
To register for a webinar, simply send the following details by email for each attendee to MRxPR@MagellanHealth.com:
- Webinar date and time (please choose 1 from the list above)
- Physician name and/or name of group or hospital
- Tax ID number
- Practice address
- Email and phone contact information