July 01, 2022

July 2022 policy and protocol updates overview

Your notice of protocol and policy changes from UnitedHealthcare

Appendix Bulletins

Medical policy updates: July 2022
Medical policy updates for July, 2022 for the following plans: Medicare, Medicaid, Exchanges, and commercial.

Reimbursement policy updates: July 2022
See the latest updates for reimbursement policies.

Specialty Medical Injectable Drug program updates: June 2022
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members.

Policy and protocol updates

Delay for Tennessee: Home health review process
Please be aware of a change to the prior authorization requirement announced in April for home health services.

CHIP copayments for mental health and substance use disorder services
Texas HHSC is prohibiting copayments for outpatient office visits, inpatient services and residential treatment services.  

Three drugs added to the specialty pharmacy drug list 
We’re adding certain specialty medications to our specialty pharmacy requirements drug list for UnitedHealthcare commercial plans.

New home health prior authorization review process 
Connecticut, Florida, Indiana and Ohio will need to request prior authorization for all visits after the SOC visit.

Access procedures requiring prior authorization beginning Oct. 1
Prior authorization will be required for a number of procedures across various service areas.

Prior authorization no longer required for certain CPT codes
Exchange plans, as of Oct. 1, 2022, prior authorization and notification is no longer required for specific CPT codes.

Other UnitedHealthcare news

Refer patients to a Designated Diagnostic Provider
On July 1, 2022, our tiered benefit for major imaging services went into effect for our fully insured commercial members.

2022–2023 Preferred Lab Network expansion 
We are excited to announce a list of labs selected to be part of the Preferred Lab Network, effective July 1, 2022.

New additions to Cancer Therapy Pathways Program
As of July 1, 2022, Hodgkin lymphoma and renal cell carcinoma have been added to our Cancer Therapy Pathways Program.

EVV requirement for HHCS begins July 1, 2022
In-home health care professionals will be required to demonstrate progress towards using an electric visit verification (EVV) system.

Metabolic screening for children and adolescents 
Resources are available for child or adolescent patients prescribed antipsychotic medications. 

Resources for antidepressant medication management
Access behavioral health resources and treatment planning for medical providers.

Resources for children and adolescents prescribed antipsychotic medication
Children and adolescents prescribed antipsychotic medication may need additional services to help support them as they work to manage their condition. 

ADHD medications: Follow-up care and resources for children
Access resources on screenings and follow-up care to assist you in developing a treatment plan for members prescribed with ADHD medication.