1199SEIU Funds Implementation Resources

"Effective 1/1/2023, 1199SEIU Benefit Funds Medical Oncology prior authorization program will begin accepting prior authorization requests for pediatric and adult Medical Oncology outpatient clinical drug trials through EviCore healthcare. The new process will still be submitted through http://www.EviCore.com, or by phoning 888-910-1199."

“Effective 10/1/2021, 1199SEIU Benefit Funds Medical Oncology prior authorization program will incur a slight change in oncology based primary treatment regimen requests with the Biosimilar First Program. The program steers to the use of preferred products within the trastuzumab, bevacizumab, and rituximab therapeutic classes. The utilization of at least one preferred product will be required prior to the approval of a non-preferred product. The new process will still be submitted through www.EviCore.com, or by phoning 888-910-1199. Both preferred and non-preferred products still require prior authorization. Selection from the list will be made and a clinical questionnaire will be completed to confirm medical necessity.”