For Providers

Generations Advantage Part B Step Therapy for Drugs & Biologics Begins January 1, 2022

Only non-preferred products will require prior authorization. Product-specific drug authorization request forms are now available in our Forms and Documents page. These forms should be completed and submitted with your request along with supporting medical records. 

For members who’ve already received treatment with a non-preferred product within the past 365 days, step therapy requirements do not apply but prior authorization is still required. On the drug-specific authorization form there is a checkbox to indicate prior use of the non-preferred product.

NDCs are required on ALL (preferred and non-preferred) step therapy drug claims and on some authorization request forms.

Authorization requests for non-preferred products can be submitted now for services in January 2022. See details on our Authorization Page.
 

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