Effective June 7, United Healthcare will require and Optum will manage prior authorization for the following outpatient radiation therapies:
- Proton beam therapy
- Fractionation for intensity-modulated radiation therapy, proton beam therapy and standard 2D/3D radiation therapy for prostate, breast, lung and bone metastasis cancers
- Image-guided radiation therapy
- Special and associated radiation therapy services
- Selective internal radiation therapy, Yttrium 90 and implantable beta-emitting microspheres for treatment of malignant tumors
The requirements affect United Healthcare's Medicare Advantage, West Medicare Advantage and Community Plan health plans.
The management of existing prior authorization requirements for intensity-modulated radiation therapy and stereotactic body radiation therapy will also transition to Optum on June 7.