September 2021 Network Bulletin overview

Your notice of protocol and policy changes from UnitedHealthcare

Appendix Bulletins

Prior Authorization

  • Hysterectomy prior authorization criteria change
    NJ, PA
    Effective Nov. 1, 2021, UnitedHealthcare Community Plans (Medicaid, Long-Term Care) in New Jersey and Pennsylvania will have a criteria change to an existing hysterectomy prior authorization.

More state and regional policy and protocol updates

  • Medical PRAs won’t be mailed after November
    AK, AL, FL, GA, IL, IN, IA, KS, KY, LA, MI, MN, MS, MO, NE, NC, ND, OH, OK, SC, SD, TN, WI
    Effective Dec. 10, 2021, for most* UnitedHealthcare plans in the region, we will no longer print and mail paper provider remittance advice (PRAs) for medical claims to network health care professionals and facilities (primary and ancillary).
  • Medicare Advantage Service Area Reductions 2022
    Effective Jan. 1, 2022, some of your patients may be impacted by UnitedHealthcare Medicare Advantage plan service area reductions or plan terminations. Non-renewal notices dated Oct. 2, 2021, will be sent to impacted members.
  • Texas: Maternal level-of-care reimbursement
    Effective Dec. 1, 2021, we will reimburse maternal services for Medicaid members receiving care in your facility that align with the assigned Texas Health and Human Services Commission (HHSC) level-of-care designations.

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