December 01, 2023

December monthly overview

Network News is published twice a month. See updates below.

December 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for December 2023 for the following plans: Medicare, Medicaid, Exchanges and commercial.

Reimbursement policy updates
See the latest updates for reimbursement policies. 

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

Pharmacy and clinical updates
Access upcoming new or revised clinical programs and implementation dates for UnitedHealthcare plans.

State news

Hawaii: Help improve patient care with ADA training
The Americans with Disabilities Act training is now available to you and your staff.

New Jersey: Tools to help you with NJ FamilyCare redeterminations
Please remind your patients to act quickly if they receive a NJ FamilyCare renewal notice.

New York: Bariatric surgery requirement updates
As of Jan. 1, 2024, we won’t require a Center of Excellence review for bariatric surgery for New York Oxford plan members.

Texas: New AI technology helps improve birthing experience
We are partnering with app developer Delfina to help provide better health outcomes throughout pregnancy.

Prior authorization updates

Neighborhood Health Partnership prior authorization reduction
Starting Jan. 1, 2024, Neighborhood Health Partnership will remove the prior authorization requirement for observation admissions.

Prior authorization required for GLP-1 medications
Starting Jan. 1, 2024, we’ll require prior authorization on covered glucagon-like peptide-1 (GLP-1) incretin mimetics.

Home health prior authorization review process changes, effective Jan. 1, 2024
Starting Jan. 1, 2024, we're changing the process for home health services for some delegated Medicare Advantage members.

Plan and program updates

2024 Medicare Advantage plan updates
See what’s new for UnitedHealthcare® Medicare Advantage and DSNP plans in your area.

Network updates for some GEHA members
Starting Jan. 1, 2024, Government Employees Health Association (GEHA) members in multiple states will use the Choice Plus network.

The PLN application process is open
Annual applications are open for UnitedHealthcare Preferred Lab Network.

Payment change for Medicare Supplement member deductibles
Starting Jan. 1, 2024, we are expanding EZ Claim Pay, a service for some Medicare members, to several new states.

Covid medication news

COVID-19 oral antiviral commercialization
Get details on COVID-19 oral antiviral commercial supply coverage.

Prescription drug list updates

Caring for patients with sickle cell disease
Know the latest sickle cell disorder guidelines to help reduce morbidity and mortality.

December 14 publication

State news

Texas Medicaid: Payment platform adjustments coming soon
We’ll soon be implementing rate revisions for ASCs and HASCs based on updated guidelines from HHCS.

Texas: Prior authorization updates for certain medications
Starting Jan. 15, 2024, we're updating prior authorization requirements for certain medications.

Wisconsin Medicaid: Avoid claim denials for DME
Starting Jan. 1, 2024, the number of days listed on DME claims must equal the number of days within the dates of service range.

Prior authorization updates

Mohs Micrographic Surgery prior authorization changes
As of Dec. 1, 2023, we won’t require prior authorization for CPT codes 14020, 14021 and 14061 with a skin cancer diagnosis.

Peoples Health transition

Prepare for the Peoples Health transition
Explore resources to help you get ready for the Peoples Health transition on Jan. 1.

Online tools and resources

New fields added in My Practice Profile
We’ve added new demographic fields for you to complete in your My Practice Profile.

Have you tried our new colorectal cancer screening tool? 
The colorectal cancer screening shared decision-making tool can help educate patients on non-invasive options.

Make a difference in a child’s life
The UnitedHealthcare Children's Foundation provides medical grants to help families cover their child's medical expenses


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