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Call our Provider Services Center at 877-842-3210

Visit UHCCommunityPlan.com

Maryland | Spring 2020

For the latest on COVID-19, visit the Centers for Disease Control at CDC.gov.

For UnitedHealthcare benefits information and resources related to COVID-19, visit UHCprovider.com/covid19. We encourage you to view the latest COVID-19 information from Maryland Medicaid.

Practice Matters: MD –. Spring 2020 Provider Services Center: 877-842-3210

Important information for health care professionals and facilities

Policy, drug and Protocol changes contained herein are effective and enforceable as of the dates indicated, pending notice from UnitedHealthcare to the contrary. Changes to these effective dates or updates to our business practices and policies as a result of COVID-19 will prevail and be posted on our care provider website as quickly as possible. As with any public health issue, we are working with and following guidance and protocols issued by federal, state, and local health authorities.

We understand that it’s a confusing time. Right now, you need all the resources and information you can get. We’re working to keep you updated so you can focus on keeping Maryland residents healthy and safe.

First and Foremost, Thank You.As the people on the front lines of COVID-19, we appreciate your efforts to fight this virus. To all health care professionals who are caring for sick patients and working around the clock to help find solutions — thank you for all you’re doing.

Find the Up-To-Date Information You NeedWe’ll be regularly updating the National UHCprovider.com page with our actions on updating state-specific guidance at your state-specific UHCprovider.com page. We also suggest that you check your state’s COVID-19 site for the latest news and regulations.

To Help Manage Your Business

• Acceleration of Claim Payments• Extension of Timely Filing Limits• CARES Act Information• Provisional Credentialing• Requirements to Practice in a New Location• Changes to Prior Authorization Requirements• Updates on Delayed Programs and Policies

On our sites, you’ll find information:

As You Work With Patients

• Expanded Telehealth Access and Reimbursement• Telehealth Coding Guide• Member Cost-Share Waivers• Assistance with Patient Discharge Planning• Easier Access to DME and Supplies• Suspension of HouseCalls and Optum at Home

Practice Matters: MD –. Spring 2020 Provider Services Center: 877-842-3210

Important information for health care professionals and facilities

In This Issue...• PreCheck MyScript® Tool

• Second Quarter 2020 Preferred Drug List Update

• Asthma Medication Ratio: Helping Members Understand

• 2019 CAHPS Member Experience Survey Results

• Support for Language Services

• The REM Program

• UnitedHealthcare On My Way Website Supports

• Do Your Male Patients Share Their Feelings?

We hope you enjoy the spring edition of Practice Matters. In this issue, you can read about support for language services, the 2019 CAHPS member experience survey results, the REM Program, and much.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33681 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32101

Important information for health care professionals and facilities

PreCheck MyScript Tool The PreCheck MyScript® tool provides real-time, patient-specific prescription data.

You can use the tool to:

• Find out if a proposed prescription requires prior authorization or is non-covered or non-preferred.

• Request prior authorization, if needed, and check the status of the request.

• View the current out-of-pocket costs for the member along with any available lower-cost prescription alternatives.

To access PreCheck MyScript, go to UHCprovider.com > Service Links > Link Self-Service Tools > PreCheck MyScript Solution.

If you need assistance with PreCheck MyScript, call the UnitedHealthcare Connectivity Help Desk at 866-842-3278, option 1, 8 a.m. to 10 p.m. Eastern Time, Monday through Friday.

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Second Quarter 2020 Preferred Drug List UpdateUnitedHealthcare Community Plan’s Preferred Drug List (PDL) is updated quarterly by our Pharmacy and Therapeutics Committee. Please review the changes and update your references as necessary.

You may also view the changes at UHCprovider.com > Menu > Health Plans by State > Maryland > Medicaid (Community Plan) > Pharmacy Resources and Physician Administered Drugs.

We provided a list of available alternatives to UnitedHealthcare Community Plan members whose current treatment includes a medication removed from the PDL. Please provide affected members a prescription for a preferred alternative in one of the following ways:

• Call or fax the pharmacy. • Use e-Script. • Write a new prescription and give it directly to

the member.

If a preferred alternative is not appropriate, please call 800-310-6826 for prior authorization for the UnitedHealthcare Community Plan member to remain on their current medication.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33682 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32102

Important information for health care professionals and facilities

Brand Name Generic Name Comments

Aimoving™ Erenumab-aooe Injection

Indicated for the preventive treatment of migraines. Prior authorization is required.

Butrans®* Buprenorphine patch Indicated for the treatment of moderate to severe pain. Prior authorization is required.

Emgality™ Galcanezumab-gnlm Injection

Indicated for the preventive treatment of migraines. Prior authorization is required.

Idhifa® Enasidenib tablet Indicated for the treatment of relapsed or refractory acute myeloid leukemia (AML). Prior authorization is required. Available through specialty pharmacy.

Lokelma® Sodium zirconium cyclosilicate suspension packet

Indicated for the treatment of chronic hyperkalemia. Prior authorization is required.

Mulpleta® Lusutrombopag tablet Indicated for the treatment of thrombocytopenia in patients with chronic liver disease (CLD) who are scheduled to undergo a procedure. Prior authorization is required. Available through specialty pharmacy.

Olumiant® Baricitinib tablet Indicated for the treatment of moderately to severely active rheumatoid arthritis. Prior authorization is required. Available through specialty pharmacy.

Orilissa™ Elagolix tablet Indicated for the management of moderate to severe pain associated with endometriosis. Prior authorization is required.

Repatha® Evolocumab injection Indicated for the treatment of heterozygous and homozygous familial hypercholesterolemia. Prior authorization is required. Available through specialty pharmacy.

Tibsovo® Ivosidenib tablet Indicated for the treatment of relapsed or refractory AML. Prior authorization is required. Available through specialty pharmacy.

Udenyca™ Pegfilgrastim-cbqv syringe

Indicated to decrease the incidence of infection in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs. Prior authorization is required. Available through specialty pharmacy.

Zepatier® Elbasvir-grazoprevir tablet

Indicated for the treatment of hepatitis C. Prior is authorization required. Available through specialty pharmacy.

*Only generics are preferred.

Removed from PDLBrand Name Generic Name Comments

Diabinese® Chlorpropamide tablet Glimepiride and glipizide are alternate options. Current utilizers will be grandfathered.

Orinase® Tolbutamide tablet Glimepiride and glipizide are alternate options. Current utilizers will be grandfathered.

Tolinase® Tolazamide tablet Glimepiride and glipizide are alternate options. Current utilizers will be grandfathered.

Zytiga® 500mg

Abiraterone tablet Abiraterone 250mg tablets are an alternate option. Current utilizers will not be grandfathered.

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Changes become effective April 1, 2020.

PDL Additions

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33683 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32103

Important information for health care professionals and facilities

PDL Update Training on UHC On AirOn UHC On Air, we have an on-demand video highlighting this quarter’s most impactful PDL changes.

• Link users can access UHC On Air by selecting the UHC On Air tile on their Link dashboard. Then, go to Maryland and click on UnitedHealthcare Community Plan. You’ll find the Preferred Drug List Q2 Update in the video listings.

• To access Link, sign in to UHCprovider.com by clicking the Link button in the top right corner. If you don’t have access to Link, select the New User button.

• To learn more about Link, visit UHCprovider.com/Link.

If you have any questions, call the UnitedHealthcare Community Plan Pharmacy Department at 800-310-6826.

Asthma Medication Ratio: Helping Members UnderstandAre your asthmatic patients experiencing an increase in asthma exacerbations? Are they visiting the emergency room or urgent care more frequently and being admitted to the hospital as a result?

This may be due to lack of adherence to their asthma care plan, which often includes decreased use of long-term controller medications and increased use of short-acting inhalers. This pattern is a key indicator that your patient’s asthma may not be well-controlled.

Discussing why your patient is using their rescuer more often than their controller medication can make a difference in their understanding of how to better manage and improve their asthma status. Exploring your patient’s experience will give you the opportunity to reinforce their understanding of your instructions and treatment plan, and it will help you creatively problem solve together.

UnitedHealthcare can provide you with a list of your patients who are our members who have an asthma medication ratio greater than 0.50. This list can be used to schedule an office visit to discuss their asthma medication usage.

For health plan assistance, you can also refer these members to our Special Needs Unit at 800-460-5689 or Member Services at 800-318-8821, TTY 711.

2019 CAHPS Member Experience Survey ResultsAnnually, our members are asked to take a survey to learn more about their level of satisfaction with services received from our care providers and UnitedHealthcare. The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) adult and child results we obtain from our members are used to identify our strengths and weaknesses. The survey results offer an opportunity to identify the key drivers of success and areas for improvement to increase member satisfaction.

The following survey results show areas where UnitedHealthcare improved or remained the same:

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Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33684 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32104

Important information for health care professionals and facilities

2019 Member Satisfaction Survey — Adult Results

2019 Member Satisfaction Survey — Child Results

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Full survey results are available at UHCprovider.com/en/health-plans-by-state/maryland-health-plans/md-comm-plan-home/md-cp-news.html.

UnitedHealthcare will continue to work with our care provider partners to meet the needs of our members.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33685 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32105

Important information for health care professionals and facilities

When members are enrolled in REM, they disenroll from UnitedHealthcare Community Plan. Enrollment is voluntary. An assigned REM case manager provides integrated coordination of services to help members with complex or special health care needs reach their greatest potential. REM referrals may be submitted by the member, family or care provider.

For a list of REM-eligible diagnoses and/or a REM application, call the UnitedHealthcare Special Needs Unit at 800-460-5689 or the REM office at 800-565-8190.

UnitedHealthcare On My Way (OMW) WebsiteEvery day, thousands of young adults make the move to independent living. For many, this is a daunting challenge because they lack critical skills needed for the realities of adult life. Through conversations with foster youth, foster parents and experts, UnitedHealthcare developed uhcOMW.com, an interactive website that guides and supports youth through their journey to become independent members of their community.

The website helps young people deal with real-world situations that may affect their futures. UnitedHealthcare OMW™ can help with managing bank accounts, securing housing, creating a resume, finding job training, applying for college and more.

How You Can HelpDo you know a young person who needs help planning for their future? Please tell them about this free resource that can help them transition to adulthood. The website can be used by anyone, not just UnitedHealthcare members. They can access UnitedHealthcare OMW at uhcOMW.com.

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Support for Language Services UnitedHealthcare Community Plan serves a diverse group of members who have a variety of cultural and language needs. UnitedHealthcare supports care providers in providing competent cultural and language services to its members in a variety of ways.

Here’s what care providers need to know:

• Although the predominant languages spoken by our Maryland members are English and Spanish, we have a significant Vietnamese population.

• We provide language assistance to help you communicate with our members that includes a telephone language line, in-person interpreters and video services.

• We have tools to promote cultural awareness and assist care providers in recognizing and treating health disparities.

• Resources and tools are available at UHCprovider.com/MDCommunityPlan, including:

– A Quick Reference Guide — Understanding Cultural Competency and the Americans with Disabilities Act

– Cross Cultural Health Care Program – Cultural Orientation Resource Center

For more information on how to get language assistance and interpreter services, call Provider Services at 877-842-3210.

The REM ProgramThe Rare and Expensive Case Management (REM) program is offered by the State of Maryland to Medicaid HealthChoice members who meet certain qualifications or diagnoses. These diagnoses are defined as rare in occurrence and expensive to treat.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33686 Practice Matters: MD – Spring 2020 Provider Services Center: 877-842-32106

Important information for health care professionals and facilities

Benefits of Using UnitedHealthcare OMW™Through UnitedHealthcare OMW, users can learn about important life topics, engage with their peers and be rewarded with virtual points, badges and messages of encouragement as they progress through six life tracks:

• Money: Create a budget and learn how to save money and do taxes.

• Housing: Understand and compare affordable housing options.

• Work: Create a resume and get interview tips.• Education: Decide what to do after high school.• Health: Learn important health information and get

answers to common health questions.• Transportation: Find out how to get around.

Using the UnitedHealthcare OMW virtual vault housed in the cloud, users can upload important documents like immunization records, medication lists, school transcripts and resumes for on-the-go access. This is especially helpful for young people in foster care who often live in a mix of group home locations and transitional housing. The virtual vault allows them to easily access their important paperwork, no matter where they currently live.

For More Information

• View our YouTube video

• Visit uhcOMW.com > Questions

• Contact the Special Needs Department at 800-460-5689.

Do Your Male Patients Share Their Feelings?It may be difficult for male patients to acknowledge and share how they’re feeling. Although “male-type” or “masked” depression is on the rise, you can encourage male patients to be aware of their emotions and give them tips on how to positively redirect anger and aggression.

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You can be their champion by giving them recommendations on how to be more comfortable communicating their feelings and asking for help. You also can promote self-management and help normalize male expression of depressive symptoms by creating a safe space for them to share their emotions.

Engaging your male patients in conversation about their feelings can aid in debunking the myth that men acknowledging and sharing their emotions is a sign of weakness. It also allows you to foster an open and honest relationship with your patients, promoting trust and compliance with the recommended care plan.

Practice Matters is a quarterly publication for physicians and other health care professionals and facilities in the UnitedHealthcare network.

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