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Medical policy updates: June 2022
This month, you’ll find updates to our commercial, commercial affiliate, Exchange Plans, Community Plan, and Medicare Advantage medical policies.
Reimbursement policy updates: June 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.
Arizona, Missouri and Washington, D.C.: Medicaid prior authorization and clinical decision letters will no longer be mailed
Beginning Sept. 9, 2022, we will no longer mail prior authorization and clinical decision letters for most UnitedHealthcare Community Health Plans to network health care professionals and facilities in Arizona.
Connecticut: Provider participation agreement terminations require 90-day written notice
According to Connecticut General Statutes Sec. 38a-0472f, a party terminating a provider's participation agreement must provide 90-day written notice.
Indiana: Reimbursement is available for COVID-19 vaccine counseling services
Effective for dates of service on or after Nov. 2, 2021, the Indiana Health Coverage Programs (IHCP) will reimburse providers for providing COVID-19 vaccine information and/or education to members.
Kentucky, Missouri, Ohio and Washington, D.C.: Medicaid PRAs are going paperless
Effective Sept. 9, 2022, we will no longer print and mail paper provider remittance advice (PRAs) for most UnitedHealthcare Community Health Plans to network health care professionals and facilities (primary and ancillary) in Kentucky.
Louisiana Medicaid: Updated urine drug testing policy from LDH
We’re sharing a policy update from the Louisiana Department of Health (LDH) regarding urine drug testing. This update applies to UnitedHealthcare Community Plan members in Louisiana.
Louisiana Medicaid: Policy updates from the Louisiana Department of Health
LDH Informational Bulletin 21-29 announced an updated policy for cochlear implant services (CPT® code 69930), effective Jan. 29, 2022.
Minnesota: Starting Sept. 9, medical claim-related letters are going paperless
Effective Sept. 9, 2022, we will no longer print and mail the following medical claim-related letters for most commercial and UnitedHealthcare Medicare Advantage health plans and Community Health Plans.
Missouri: Review CPT code changes for obstetrical services effective Aug. 1
Effective Aug. 1, 2022, providers in Missouri are required to submit claims with the Current Procedural Terminology (CPT) codes for obstetrical service provided to Medicaid plan members.
Pennsylvania Medicaid: Billing updates for personal care services
Effective May 1, 2022, the Pennsylvania Department of Human Services (DHS) has updated its billing requirements for personal care services that are verified using an electronic visit verification (EVV) system.
Prior authorization requirements for shoulder surgery service codes starting Aug. 1
Effective Aug. 1, 2022, we will require prior authorization for all shoulder surgery service codes for UnitedHealthcare Community and State health plan members.
Prior authorization changes coming to UnitedHealthcare Community Plan of Texas for certain behavioral health services
Effective June 1, 2022, prior authorization will no longer be required for psychotherapy services.
New codes added to the prior authorization list for Commercial plans
Starting Sept. 1, 2022, we’re adding additional codes to the prior authorization list for UnitedHealthcare Commercial plans.
Medicare Advantage: Prior authorization required for post-acute care facility admission
Facilities contracted with UnitedHealthcare and providing post-acute inpatient services for UnitedHealthcare Medicare Advantage members are required to obtain prior authorization before members can be admitted to a post-acute care facility.
Verify and update your demographic data to avoid directory removal
Beginning July 1, 2022, if we can’t verify your information, you’ll be removed from the UnitedHealthcare provider directory. Please verify and attest to your demographic data accuracy today.
Overpayment letters won’t be mailed after Sept. 9
Beginning Sept. 9, 2022, we will no longer mail overpayment notification letters sent directly by UnitedHealthcare for most commercial and UnitedHealthcare Medicare Advantage plans.
Arizona Medicaid: Review required courses for health care professionals serving Arizona CSOC
Provider agencies that serve children and adolescents in the Arizona Children’s System of Care (CSOC), and that have employees who facilitate Child and Family Team Meetings (CFTs), are required to take two courses.
Hawaii: Explore pharmacy prior authorization resources
Access prior authorization resources to help when prescribing patients medication.
Indiana Lead Screening Guidelines and Reporting for Children Enrolled in Medicaid
Indiana statute requires that all children enrolled in Medicaid are to receive a blood lead level test at 12 and 24 months of age. Additionally, the state requires that any child enrolled in Medicaid between 36 and 72 months with no record of a previous blood lead test must also be tested.
Louisiana Medicaid: Become certified to administer fluoride varnish to children
The Louisiana Department of Health has approved primary care physicians (PCPs) and other health care professionals to administer dental fluoride varnish treatment to children enrolled in Medicaid.
Maryland: Help your Medicaid patients prevent and manage Type 2 diabetes
If you care for patients in Maryland who have prediabetes or are at risk for getting Type 2 diabetes, the HealthChoice Diabetes Prevention Program (DPP) can help.
Michigan Medicaid: MDHHS launches We Treat Hep C initiative to combat hepatitis C
The Michigan Department of Health and Human Services (MDHHS) launched the We Treat Hep C Initiative to help eliminate the hepatitis C virus (HCV) in Michigan.
Mississippi Medicaid: Become an EPSDT certified provider in 2 simple steps
Mississippi Division of Medicaid is now requiring coordinated care organizations (CCOs) to report Early and Periodic Screening, Diagnostic and Treatment (EPSDT) compliance rates only for those providers who are currently EPSDT certified.
New Jersey: Maternity incentive payment for initial prenatal and postpartum visits begins July 1, 2022
UnitedHealthcare is excited to announce that beginning July 1, 2022, we’ll be paying a $75 incentive bonus for the initial prenatal visit and a $75 incentive bonus for the first postpartum visit.
Wisconsin Medicaid: Requirements and best practices for lead screening in children
Review state-mandated requirements for lead testing and best practices for you and your staff.
Remote patient monitoring support available for patients with Type I and Type 2 diabetes
Here’s a reminder that we offer personalized remote patient monitoring for patients living with Type 1 and Type 2 diabetes.
Refer your patients to LabCorp to ensure coverage of services
LabCorp is Arizona’s only in-network provider for laboratory service. Please refer UnitedHealthcare Community Plan members to LabCorp to make sure claims are paid in a timely manner and to avoid claim rejections.
Available resources to build COVID-19 vaccine confidence
With new variants emerging and vaccination rates plateauing, we’ve bundled together resources from trusted organizations and clinical data to aid in those tough conversations.
Improve patient care by completing self-paced Cultural Competency Training
This training discusses why cultural competency and the Americans with Disabilities Act (ADA) requirements are important for care providers.
2021 Quality Improvement program overview
We conduct annual surveys as part of our Quality Improvement (QI) program to better understand the experiences of our members and the health care professionals who serve them.
New Smart Edits available for behavioral health
Smart Edits is now available for behavioral health care professionals to help repair claims with potential errors.