This pharmacy bulletin outlines new or revised clinical programs and implementation dates. It’s available online for UnitedHealthcare commercial and UnitedHealthcare Oxford commercial plans.
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.