Ambetter from Magnolia Health Partnering with New Century Health

Date: 11/19/21

Ambetter from Magnolia Health is pleased to announce its collaboration with New Century Health (NCH), an oncology quality management company, to implement a new prior authorization program. The program will simplify the administrative process for providers to support the effective delivery of quality patient care.

Beginning 12/1/2021, oncology-related infused, oral chemotherapeutic drugs/supportive agents, and radiation treatments will require a prior authorization from NCH before being administered in either the provider’s office, outpatient hospital, ambulatory setting, or infusion center. Prior authorization reviews be subject to NCH’s clinical policies. This requirement applies to Ambetter from Magnolia Health members of all ages.

Prior Authorization Process:

The requesting physician must complete an authorization request using one of the following methods:

• Logging into the NCH Provider Web Portal: 
• Calling 1-888-999-7713
  • Medical Oncology - Option 1 
  • Radiation Oncology - Option 2 

Monday–Friday 8 AM to 8 PM EST

Medications Impacted:

Ambetter from Magnolia Health’s Oncology Pathway Solutions Program, administered by New Century Health, requires prior authorization management for all chemotherapeutic drugs, symptom management drugs and supporting agents for members with a cancer or hematology diagnosis code.

Specialties included are Medical Oncology/Hematology, Pediatric Medical Oncology/Hematology Gyn-Oncology, Neurological Oncology, Radiation Oncology, Pediatric Radiation Oncology, Surgical Oncology, Urology, Pediatric Urology (medications only). 

Transition of Care:

Authorizations previously issued by Ambetter from Magnolia Health’s UM before 12/1/2021 will be effective until the authorization expiration date. Authorizations previously issued by Ambetter from Magnolia Health’s UM that expire on or after 12/1/2021 must be submitted to New Century Health to obtain a new valid authorization.  

Authorizations for a single drug regimen issued by Ambetter from Magnolia Health’s or Envolve Pharmacy Solutions before 12/1/2021 will remain valid until they expire.       

A New Century Health representative will contact you soon to schedule an introductory meeting. 

Ambetter from Magnolia Health Partnering with New Century Health (PDF)