Skip to Content

Provider Manual

Home IV Drug Therapies

Last Updated on May 17, 2019

Effective 1/1/19 Security Health Plan will be enhancing our home infusion benefit for select product lines by increasing the number of medications included under the benefit.  The home infusion program not only offers high-quality care but also aids in lowering the total cost of care for our members. This benefit will expand access to home infusion medications and will allow our members the convenience of receiving infusions in the comfort of their own homes.

Product lines included:
  • All Commercial lines
  • Marshfield Clinic Health System Employer Group
  • Medicare Advantage Core/Southern
  • Medicare Advantage Eastern
  • Medicare Advantage Ally Rx (D-SNP)

Our ‘Medical pharmacy’ page identifies home infusion eligible medications. To view the full list of Home Infusion eligible medications select ‘Home Infusion’ from the Category drop down. You may also search for a select medication by entering the drug code or generic/brand drug name in the ‘Search’ field. Medications that are allowed to be administered in the Home setting will be indicated with ‘Home infusion eligible’. Some of the home infusion medications will require prior authorization (PA) which will be managed through our specialty pharmacy medication partner, Magellan. Drugs that require PA will indicated with ‘Prior Authorization is required’.

For the Medicare Advantage product lines listed above all Home Infusion services must be provided by an affiliated Home Infusion provider to be covered. For Commercial product lines that have an out of network benefit, members are eligible to see any licensed provider. Security Health Plan recommends you use an affiliated Home Infusion provider to keep the cost of care lower for our members.

Security Health Plan has contracted with the following Home Infusion Providers:
  • Specialty Medications:
    • Accredo
      • Phone: (866) 759-1557
    • Fairview
      • Phone: (612) 672-2233
    • Ascension (IVIG only for Commercial products)
      • Phone (715) 301-7160
  • Traditional Medications:
    • Fairview
      • (612) 672-2233
    • Option Care
      • (888) 256-7234
    • Ascension (only select traditional medications)
      • Phone (715) 301-7160

Procedure for ordering providers

  • Use the ‘Medical pharmacy’ page to determine if the medication is Home Infusion eligible
  • Contact one of the affiliated Home Infusion providers listed above to initiate treatment
  • If medication requires PA the Home Infusion provider will initiate the PA through Magellan


Magellan Home Infusion PA List

Security Health Plan prior authorizes certain home IV drug therapies with affiliated vendors and conducts concurrent review of the same in order to determine medical necessity, contain costs through efficiency of care, actively manage members identified as high risk for complicated care needs, and evaluate appropriate use of resources to ensure optimal results for members.

To determine if a medication requires PA refer to the ‘Medical pharmacy’ page and search for the desired medication. If the drug requires PA it will be indicated with ‘Prior Authorization is required’.

To view prior authorization criteria or to submit an authorization to Magellan Rx click the ‘Submit a prior authorization’ link. 

Submit a prior authorization

  

Procedure for dates of service prior to 1/1/2019

  • The vendor will be responsible to call Security Health Plan to prior authorize home IV drug therapies if additional registered nurse visits are necessary.
  • The hospital discharge planner/social worker will contact Security Health Plan Customer Service to verify benefits. 
  • Security Health Plan Customer Service will verify benefits. A Security Health Plan staff member will inform the discharge planner/social worker of Security Health Plan’s preferred providers and instruct him/her to have the vendor call with physician’s orders.