Provider News & Updates – September 2023 September 12, 2023 Optum Specialty Fusion to Manage Prior Authorizations On Aug. 1, 2023, Optum Specialty Fusion began managing prior authorization requests for select outpatient provider-administered specialty and oncology drugs for Samaritan Health Plans and InterCommunity Health Network Coordinated Care Organization. Prior authorization requests for these services must now be submitted using the Specialty Fusion platform for dates of service on or after Aug. 1. Authorizations that were active prior to this date will remain in effect through any approved dates of service. You will not need to submit a new request until the existing authorization expires, even if the dates of service on the approved authorization are after Aug. 1. A current list of drug codes and procedures requiring Specialty Fusion review is available and can be accessed by visiting samhealthplans.org/Find-a-Drug. Due to quarterly code changes and FDA newly approved drugs, the code list will be updated on a periodic basis. Providers are responsible for verifying authorization requirements and criteria by visiting samhealthplans.org/Authorizations and navigating to the appropriate plan’s authorization and benefit information. Specialty Fusion will not be reviewing prior authorizations for: Services or procedures that are included as part of an inpatient hospitalization or skilled nursing stay. Services or procedures provided during an emergent, urgent or observation service. Prescription pharmacy drugs that are currently reviewed and managed by OptumRX, Surescripts or CoverMyMeds. Contracted providers can access the Specialty Fusion platform through the SHP provider portal, Provider Connect. As part of the request intake, clinical requirements can be documented within the required fields of the platform, including medical records attachments when requested or as appropriate. If you are not already a subscriber to the provider portal, please visit Provider Connect to create an account. For help with creating an account or navigating the application, please refer to our Provider Connect tutorial. For more information about the new prior authorization process with Optum Specialty Fusion, please contact SHP Provider Relations at email@example.com or contact SHP Customer Service at 541-768-5207 or toll free 888-435-2396.