Changes to Peoples Health prior authorization submission process

Affects specialty and oncology Part B drugs

Effective July 1, 2025, Peoples Health is changing how providers submit authorization requests for Peoples Health patients through the UnitedHealthcare Provider Portal for:

• Specialty (non-oncology) Part B drugs
• Oncology (Optum Cancer Guidance Program [CGP]) Part B drugs

The changes consolidate authorization pathways through MBMNow for both categories. Notably, the visual experience for non-oncology submissions will be different, and certain non-oncology drugs may be eligible for auto-approval.

For more information, please review the Specialty Drugs and Oncology Drugs Authorization Process Changes reference sheet.

Non-impacted processes

This process change does not apply to specialty and oncology medications ordered and/or administered for the inpatient setting. Continue to submit requests for the administration of these drugs in the inpatient setting through the UnitedHealthcare Provider Portal authorization request tool as an inpatient authorization request.

The process changes also don’t impact existing approved authorizations for Part B drugs; those will remain in effect until the end date on the authorization. You won’t need to submit a new request until the existing authorization expires or you change the therapy.

Other resources

Find oncology (CGP) Part B drugs that require prior authorization on the oral and injectable chemotherapy and related cancer therapies page.

Find specialty Part B drugs requiring prior authorization in the Medicare Advantage Prior Authorization List (under the Medicare Advantage tab, choose the link that mentions “Peoples Health”) and in the Medicare Part B Step Therapy Program policy.