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October monthly overview

Review the latest UnitedHealthcare prior authorization, medical policy, pharmacy, reimbursement, laboratory and policy and protocol updates.

Colorado, Kentucky and Tennessee: New home health review process

Starting July 1, 2022, for UnitedHealthcare® Medicare Advantage and Dual Special Needs Plans (D-SNP), you’ll need to request prior authorization for all visits after the start of care (SOC) visit.

Home health review process changes

Starting June 1, 2022, for UnitedHealthcare Medicare Advantage and Dual Special Needs Plans, we will require initial authorization and will perform continuation of care reviews for Home Health Agencies (HHAs). This change is taking place for members enrolled in Medicare Advantage plans, including Dual Special Needs plan members, who reside and receive services in Arkansas, South Carolina, and Texas.

Alabama: Home health review process changes

Starting July 1, 2022, for UnitedHealthcare® Medicare Advantage and Dual Special Needs Plans (D-SNP) in Alabama, there will be a change in the process for requesting prior authorization for all visits after the start of care visit (SOC).

Prior authorization updates for endovascular procedures

Prior authorization changes to Lower Extremity Vascular Angiography and Endovascular Revascularization procedures

New Jersey: Prior authorization and site of service expansion

As of Nov. 1, 2022, we’re expanding prior authorization and site of service for Community Plan of New Jersey.