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Learning More with Analytics

2014 FLASCO Business of Oncology Summit UnitedHealthcare Cancer Registry and Prior Authorization for Outpatient Chemotherapy Keith Singer, MD. Learning More with Analytics. The first and only cancer registry for commercially insured patients. 4,000+ Participating Oncologists.

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Learning More with Analytics

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  1. 2014 FLASCO Business of Oncology Summit UnitedHealthcare Cancer Registry and Prior Authorization for Outpatient ChemotherapyKeith Singer, MD

  2. Learning More with Analytics The first and only cancer registry for commercially insured patients 4,000+ Participating Oncologists 65,000+ UHC patients Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 2

  3. Analytics Clinical Data Existing NCCN Clinical Guidelines Claims UHC Registry Providers Oncology Care Analysis Academic Research Quality and Cost Analytics Oncologist Quality of Care Reports New Contracting Methods Reduce Gaps in Care, Build New Programs Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 3

  4. Program Overview Prior authorization is required for chemotherapy drugs administered in an outpatient setting in Florida for the treatment of cancer for Commercial and Medicaid members All methods of injection require prior authorization UnitedHealthcare uses the National Comprehensive Cancer Network (NCCN) compendium to review requests Combination of drugs and line of therapy UnitedHealthcare Cancer Drug Policy is being applied pre-service vs. after claim submission. Effective Date Beginning May 17, 2014; website available May 1, 2014 UHC2559l_20140123 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  5. Prior Authorization Process UnitedHealthcare is using a web-based application hosted by its vendor, CareCore National. Web Application: www.medicaloncologyauthorizations.com Enter physician, patient, clinical data and select/enter proposed regimen The application displays NCCN-approved regimens Ability to submit clinical information online for members with medical contra-indications to an NCCN-recommended regimen including: Comorbidity Histology Abnormal lab test Past drug reactions Peer review published literature A physician-to-physician discussion with an oncologist UHC2559l_20140123 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

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