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Prior Authorizations for Opioid Prescriptions

The Pennsylvania Department of Human Services (DHS) mandates that all Medicaid managed care organizations (MCOs) in Pennsylvania implement prior authorization requirements for opioid prescriptions. These include prior authorization requirements for M…

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Implementation of the 2017 InterQual Criteria

As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria* as a guideline for making medical necessity determinations. This week we successfully resolved a technical issue that had delayed the implementation of the 2017 criteria past o…

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The September 2017 Provider Newsletter is Now Available!

The September edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available on our Provider Newsletters web page. In this September edition, we provide information regarding DHS enrollment requirement for ordering, re…

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ONAFs Now Online

To help you transition to the online submission process for ONAFs, we’re offering a one-time incentive for ONAFs submitted via the Optum cloud ( between September 1, 2017, and December 31, 2017. Learn more below: ELIGIBILITY PERIOD: …

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