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February 01, 2024

February monthly overview

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

February 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for February 2024 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

Rocky Mountain Health Plans: Prior authorization updates starting May 1, 2024
RMHP will require prior authorization for some physician-administered medications in outpatient settings.

Your Community Plan medical claim letters are going paperless soon
Starting May 3, 2024, Medicaid claim letters won’t be mailed in Florida and Massachusetts.

May 1: Electronic reconsideration and appeal submissions required 
Health care professionals must submit Medicaid medical reconsiderations and appeal submissions electronically in Massachusetts and Mississippi.

Important update: New Missouri Tobacco Quit Services changes
Missouri Tobacco Quit Services helps Missourians quit all forms of tobacco, including e-cigarettes and smokeless tobacco.

New Jersey: Help your patients keep their health care
Your NJ FamilyCare (Medicaid) patients may need to renew their coverage. If not, they could lose their eligibility.

Texas: Prior authorization updates for certain medications
Starting March 1, 2024, we're updating prior authorization requirements for certain medications to meet state criteria.

Texas Medicaid: DME exceptional circumstances provision
Submit requests with prior authorizations for DME covered under the Home Health Exceptional Circumstances Provision.


Z-Code reminders

Make sure molecular tests have a Z-Code assigned
To get your claims paid faster, molecular tests will now require Z-Codes.


February 15 publication

State news

New Jersey: Refer patients to Oxford Preferred Lab Network
You can help reduce patients’ out-of-pocket costs by referring them to the Oxford Preferred Lab Network.

Expand your practice’s reach
Attesting to your data helps display your practice’s accurate location, simplifying the path to your care.

New maternity benefits for pregnant members
UnitedHealthcare Community Plan of Texas now offers doula and Mom’s Meal services.

Wisconsin Medicaid: Requirements and best practices for lead screening in children
Wisconsin DHS requires all children enrolled in Medicaid to receive blood level tests at set ages. Learn more.

Wisconsin Medicaid: Help children access preventive care
See how HealthCheck, a Medicaid benefit from Wisconsin DHS, helps ensure access to preventive care


Black History Month resources

Advance healthy equity during Black History Month
Complete free CEU courses that support cultural competency and social drivers of health.

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