Buckeye Health Plan - Change in Prior Authorization Requirements

As of October 1, 2017, Buckeye Health Plan (Buckeye) made changes to services requiring prior authorization.

Please note the following important changes:
• Infliximab-dyyb, Inflectra, Q5102
• Pegfilgrastim, Neulasta, J2505
• Rituximab, Rituxan, J9310
• Bevacizumab, Avastin, J9035
• Pemetrexed, Alimta, J9305
• Cetuximab, Erbitux, J9055
• Ipilmumab, Yervoy, J9228
• Brentuxumab Vedotin, Adecetris, J9042
• Darbepoetin Alfa for ESRD on dialysis, Aranesp, J0882
• Panitumumab, Vectibix, J9303
• Bendamustine, Faslodex, J9033
• Cyclophosphamide, Cytoxan, J9070
• Nivolumab, Opdivo, J9299

Prior authorization is now required for the above codes in all care settings including inpatient and outpatient hospitals and ambulatory care centers. To obtain more detailed information or assistance, please visit Buckeye’s website at www.buckeyehealthplan.com/providers or contact Buckeye's Provider Services at 866-296-8731.

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