Magellan Rx Specialty Drug Program
Posted on October 28, 2015
Effective 1/4/16, Health New England will be implementing a change in the way we manage certain specialty drugs that fall under the medical benefit. We will now be requiring prior authorization for the following drug areas:
- Oncology, Oncology Support (antiemetic, neutropenia)
- Anemia
- Hereditary Angioedema
- Inflammatory Conditions
- Immunodeficiency (IVIG)
HNE also will be implementing a post service pre-payment claim edit program for certain specialty drugs that fall under the medical benefit for Oncology, Endocrine Disorders, Inflammatory Conditions, Macular Degeneration, and Osteoporosis.
This new program will be administered by Magellan Rx Management (Magellan Rx). Magellan Rx will assist with the new process for reviewing and approving these specialty drugs for all lines of HNE business (Commercial, Medicare and Medicaid).
For more information, please review these helpful resources:
- HNE Magellan Rx Medical Pharmacy Overview
- Frequently Asked Questions
- Magellan Rx Medical Pharmacy Program Drug List
Please contact Health New England Provider Relations with any questions at (413) 233-3313 or (800) 842-4464, ext. 5000.
