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Wellcare partners with New Century Health (NCH) for oncology prior authorization program

Date: 01/18/23

Fort Lauderdale, Florida

Wellcare has partnered with New Century Health (NCH) to implement a new oncology prior authorization program, Oncology Pathway Solutions. This program is intended to help providers easily and effectively deliver quality patient care.

Effective April 1, 2023, oncology-related chemotherapeutic drugs including supportive agents and radiation oncology treatments will require pre-authorization from NCH before being dispensed at a pharmacy or administered in a physician’s office, outpatient hospital or ambulatory setting. This requirement applies to your Medicare members ages 18 and older.

 Prior authorization can be requested by:

  • Visiting NCH’s Web portal or
  • Calling 1-888-999-7713, Option 1 (Monday-Friday, 8 a.m. to 8 p.m. Eastern)

NCH uses clinical criteria based on nationally recognized guidelines to promote evidence-based cancer care. When using the web portal, you can obtain real-time approvals by selecting evidence-based NCH treatment care pathways. You will also be able to determine which clinical documentation is needed for medical necessity review, and view all submitted requests in one location. You may also request to speak with an oncologist to discuss treatment options.

For Medicare membership in the Plans, approvals issued by Wellcare before April 1, 2023, are effective until the authorization end date, unless there is a change in treatment, at which point you must submit a request for authorization. Starting April 1, 2023, please submit prior authorization requests to NCH.

Wellcare is proud to be your healthcare partner. If you frequently prescribe oncology medications and are new to this process, an NCH representative will contact you to schedule an introductory meeting and training. If you are new to NCH, portal login credentials will be securely emailed to you after your meeting and before April 1, 2023. If you need access to NCH’s portal and have not received a call from NCH or if you have questions, email providertraining@newcenturyhealth.com or call 1-888-999-7713, Option 6. You may also call Wellcare Provider Services at 1-855-538-0454 or visit the Wellcare website. We are here to help.