Medicare: Updated prior authorization process for certain oncology procedures

Effective June 1, 2026, you’ll need to begin submitting prior authorizations for outpatient chemotherapy services using the Optum® Cancer Guidance Program (CGP) for our members under the UnitedHealthcare Nursing Home Plan and the UnitedHealthcare Care Advantage Plan. This applies only to patients who have been diagnosed with cancer.

This process is similar to other UnitedHealthcare plans. Your office may already be familiar with this process if you submit prior authorizations for these services for other UnitedHealthcare plans. CGP has a high provider Net Promoter Score℠ due to its easy-to-use, intuitive platform and quick approval time.

If you need to modify an existing regimen

If you need to modify an existing regimen or treatment plan for which we already granted prior authorization approval before June 1, 2026, we’ll require you to resubmit your prior authorization request to us.

How to request prior authorization using CGP

Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
- If you don’t have a One Healthcare ID, register now
From the left-hand tabs, select Prior Authorizations & Notifications. Then, click “Create a new request.”
Select Oncology and enter the member’s state and plan details. You’ll be directed to the Optum website to complete your request.