New York
Provider Communications
Reminder: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019
What has changed?
- Beginning June 15, 2019, for all new specialty drug review requests and reauthorization specialty drug review requests that were previously performed by AIM, providers need to contact Empire’s medical specialty drug review team:
- by phone at 1-833-293-0659
- by fax at 1-888-223-0550 or
- All inquiries about an existing request (initially submitted to AIM or Empire), peer-to-peer review, or reconsideration are being managed by Empire’s medical specialty drug review team.
What has not changed?
- AIM continues to be responsible for performing medical oncology drug reviews for existing commercial medical benefit for our employer group business.
- Specialty drug review processes not previously done by AIM remain unchanged.
- Clinical criteria for medical non-oncology specialty drugs continues to reside on the clinical criteria page.
- Post Service Clinical Coverage Reviews and Grievance and Appeals process and teams have not changed.
Here is a summary of the medical specialty drug changes: Beginning June 15, 2019
Action |
Contact |
Submit a new prior authorization request for medical specialty drug reviews
Submit a reauthorization request for a medical specialty drug review previously performed by AIM |
Call Empire at 1-833-293-0659
or
Fax us at 1-888-223-0550 for
|
Inquire about an existing request (initially submitted to AIM or Empire), peer-to-peer review, or reconsideration |
Call Empire at 1-833-293-0659
|
Featured In:
August 2019 Empire Provider News