March 01, 2023

March monthly overview

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

March 1 publication

Policy and protocol updates

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

Reimbursement policy updates: March 2023
See the latest updates for reimbursement policies.

Specialty Medical Injectable Drug program updates: March 2023
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members.

Pharmacy and clinical updates: March 2023
Access upcoming new or revised clinical programs and implementation dates for UnitedHealthcare plans.

State news

How to revalidate your AHCCCS enrollment
Revalidate your enrollment every 5 years. Learn how.

AHCCCS alert on targeting activity
AHCCCS wants you to be aware of individuals targeting people who reside on tribal reservations.

Prior authorization requirement changes for radiation therapies
Effective May 1, 2023, we will require prior authorization for some radiation therapies in Kentucky.

Paperless updates for Michigan Medicaid
Starting June 2, 2023, Medicaid PRAs, prior authorizations, appeals and overpayments in MI must be viewed electronically.

Teen directed family planning code changes
Starting Jan. 1, 2023, you'll be required to use a new HCPCS code for teen-directed family planning visits.

Referrals no longer needed for most specialties
We’re removing referral requirements for most specialties.

Texas Medicaid: FMSA billing unit clarification
We want to clarify recent changes in the Financial Management Services Agencies (FMSA) billing unit.

Texas: Unit accuracy on dental anesthesia claims
Estimating time incorrectly on dental anesthesia prior authorizations will result in incorrect payments. See why.

Virginia Medicaid: Final reminder to enroll in DMAS
Medicaid managed care network providers must enroll through PRSS to comply with the 21st Century Cures Act.

Washington Medicaid digital updates
Starting June 2, 2023, Medicaid appeals and overpayments in WA will no longer be mailed and must be viewed electronically.

Policy and program changes

Home health review prior authorization updates
As of Feb. 1, 2023, prior authorization is not required for home health services for D-SNP members.

New requirements for gastroenterology services
Starting June 1, 2023, we'll require prior authorization for gastroenterology endoscopy services.

North Carolina Medicaid: HealthChoice/CHIP alert
Patients with HealthChoice/CHIP plans will transition to Medicaid on April 1.

Expanded 100-day medication supply benefit
UnitedHealthcare Medicare Advantage members can get 100-day supplies of medications for the same copay as 90-day supplies.

DATA Waiver not required for treating OUD
Removing the DATA Waiver makes medication-assisted OUD treatment more accessible. See why.

Digital updates

Paper checks phasing out for Oxford claim payments
Oxford providers now have a choice between direct deposit or virtual card payment.

Electronic payments coming for USHEALTH claims
Starting March 1, claim payments for services provided to USHEALTH plan members will only be sent via VCP or ACH direct deposit.

Update on Virtual Card Payment services
This article updates providers on the expected resumption of VCP payments in late second quarter 2023.

March 16 publication

State news

New eConsult platform for specialty care
AristaMD helps make it easier to connect with specialists and get guidance on a member’s disease or illness quickly.

EVV requirement for skilled service claims
Learn about EVV requirements for in-home services for home health care aide and private duty, effective April 1, 2023.

Medicare Advantage updates

Our 2023 Patient Experience Guidebook is here
The 2023 Patient Experience Guidebook is designed to help you serve UnitedHealthcare Medicare Advantage members.

Cardiac pacemaker coverage
We've updated billing requirements for cardiac pacemaker claims for members with Medicare Advantage plans.

Claim and ID card reminders

New ID cards for some commercial plans
Watch for new card details on select plans.

Avoid claim delays for GEHA members
It's important to include the entire member number, including the GEHA suffix, when submitting claims. Learn why.

Tools and resources

New Outpatient Procedure Grouper mapping exhibits for 2023
Effective July 1, 2023, we’re updating OPG mapping exhibits to reflect the codes that are eligible for reimbursement.

Tackle claims tasks with greater ease and speed
Use the digital solutions provided by the UnitedHealthcare Provider Portal to save time and expedite your claim-related tasks.

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