Commercial products for individual and family coverage available through MNsure, including UCare Choices and UCare Choices with Fairview
UCare for Seniors (UFS), Group UCare for Seniors, UCare Medicare Plans, UCare Medicare Plans with Fairview and North Memorial, EssentiaCare.
UCare Connect + Medicare and Minnesota Senior Health Options (MSHO)
UCare Connect (Special Needs BasicCare), Minnesota Senior Care Plus (MSC Plus), MinnesotaCare (MnCare), Prepaid Medical Assistance Program (PMAP)
The Pharmacy and Therapeutics Committee, a group of practicing physicians and pharmacists, meets up to six times per year to recommend medication inclusion or exclusion to our formularies. The Pharmacy and Therapeutics Committee evaluates drugs based on clinical evidence and efficacy (drug monographs, peer reviewed literature, compendia resources), therapeutic guidelines, medication safety and comparable data to other therapeutic alternatives. This committee reviews all new drugs approved by the FDA, new generics, new dosage forms, new indications as well as regular therapeutic class reviews and annual review of all utilization management criteria.
612-676-3300 or 1-888-531-1493
Hours: 8 a.m. to 5 p.m., Monday through Friday
In this edition, read about changes for PCA and HCN services billed to members under age 65, new product names, 2019 Opioid Edits, enhanced prior authorization DME/Supply form, and documentation improvement for MI.
This bulletin provides a summary of the UCare pharmacy formulary changes taking effect Jan. 1, 2019. Plan names have changed for 2019 for Medicare plans and Individual & Family plans.
UCare's 2019 authorization and notification requirements are now available on our website at ucare.org/providers, under the Eligibility & Authorization section: State and Public programs, UCare Medicare Pans, EssentiaCare, Behavioral Health and Pharmacy.
During 2019, UCare will temporarily suspend the requirement for prior authorizations for services delivered to members with UCare Choices and Fairview UCare Choices (renamed as UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview in 2019).
On July 13, the FDA announced a recall of medications containing valsartan, a generic medication used to treat high blood pressure and heart failure due to an impurity detected in the recalled products.
UCare informs providers of critical business reminders for NCQA accreditation requirements for Credentialing, Pharmacy, Complex Case Management, Utilization Management, Member Rights and Responsibilities, and Disease Management.
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