Medicare AdvantagePrior AuthHigh impact
OncoHealth program expanding to Tufts Medicare Preferred
Harvard Pilgrim Health Care·Oncology, Radiation Oncology·Provider Newsletter
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, Tufts Medicare Preferred members will require prior authorization through OncoHealth (instead of Point32Health) for all outpatient chemotherapy drugs and oncology treatments. Billing teams must learn new authorization portals and processes for oncology-related drugs while continuing to use Point32Health for non-oncology uses of the same drugs.
Action Required
Before January 1, 2026: Billing team must register for OncoHealth webinars to receive OneUM portal credentials and learn new authorization process. Update workflows to route Tufts Medicare Preferred oncology prior auths to OncoHealth (OneUM portal, fax 800-264-6128, or phone 888-916-2616) instead of Point32Health. Train staff to distinguish between oncology vs non-oncology use of drugs - same drug requires different authorization sources. Continue submitting claims to Point32Health as usual.