Change in Prior Authorization for Medicare Part B Medications

Date: 12/13/18

Sunrise, Florida

Allwell Providers: Thank you for your continued partnership with Allwell from Sunshine Health.  This notice is to inform you of changes to the prior authorization requirements for Medicare Part B medications.

Effective January 1, 2019, some Medicare Part B medications will be subject to step therapy guidelines.  The purpose of the step therapy guidelines is to ensure that lower cost medications have been tried before moving on to more expensive drug regimens.  To determine whether your patients are taking medications that are subject to the step therapy program, please use the Pre-Auth Needed tool on our website. 

If you have any questions about this program, please don’t hesitate to reach out to Provider Services at 1-844-477-8313.