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03/2019: UnitedHealthcare Credentialing Plan 2019–2021 Summary of Changes

UnitedHealthcare reviews and updates our Credentialing Plan at least every two years to maintain compliance with all state and federal regulatory requirements and accreditation requirements of the National Committee for Quality Assurance (NCQA). The 2019–2021 UnitedHealthcare Credentialing Plan will be effective June 1, 2019.

Here are some of the key changes:

  • Clarified that the Medicare and Medicaid Sanctions Review applies to all providers, regardless of line of business - Medicare, Medicaid or commercial. 
  • Clarified the role and composition of the hearing panel. 
  • Added the CMS Preclusion List requirements.