May 01, 2024

May monthly overview

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

May 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for May 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

Florida: Avoid overpayment. Learn how HRA applies to out-of-pocket costs.
Take our online course on how to determine patients’ out-of-pocket responsibilities after HRA funds are applied.

Simplify your DME orders with Synapse Health
Beginning Aug. 1, you’ll use Synapse Health for all durable medical equipment orders in Georgia and North Carolina.  

New Jersey: Denied claims will no longer be automatically reprocessed 
We will stop automatically reprocessing denied claims if you are registered for the 21st Century Cures Act program.

UHC Provider Portal security reminder

Provider portal authentication
To enhance data security, UnitedHealthcare Provider Portal and specialty portal users will be required to make One Healthcare ID sign-in and recovery updates by summer 2024.

Surest benefits plans updates

Surest medical injectable policies to align with UnitedHealthcare commercial plans policies
Starting Aug. 1, we’re updating some Surest™ medical injectable policies to align with UnitedHealthcare.

2023 Quality Improvement survey results

2023 Quality Improvement survey results
The 2023 results of our annual Quality Improvement survey are now available

May 16 publication

State news

Improve patient experience with Trellus Elevate
Trellus Elevate™ works alongside your treatment plan to provide a comprehensive support system for your patients with IBD.

Florida: Explore the benefits of implementing SBIRT in your office 
To support AHCA in its aim to reduce the impact of substance use disorders in Florida, implement SBIRT in your office.

Maryland: Fertility preservation services now covered for Medicaid members 
Starting Oct. 7, 2024, some fertility preservation services will be covered for Maryland Medicaid members.

Maryland: Expanded Medicaid coverage of gender-affirming treatments 
As of Jan 1, 2024, we now cover certain gender-affirming treatments for Maryland Medicaid members.

Michigan: Earn extra payments for patient care 
You can earn extra on top of fee-for-service payments for providing care to UnitedHealthcare Community Plan members.

Required billing for Tennessee Medicaid network health care professionals 
Submit claims for allied health care professionals with their NPI and Medicaid ID.

The Empire Plan updates

Changes to The Empire Plan enrollee benefits, effective July 1 
Effective July 1, 2024, enrollee benefits are changing for some groups in The Empire Plan. Learn more.

Asian American and Pacific Islander Month

May is Asian American and Pacific Islander Heritage Month
View our training and resources for you and your practice.


Join us for a special Surest webinar

Discover how to submit prior authorizations using the Optum® Cancer Guidance Program and Specialty Guidance Program.

Register today Join us for a special Surest webinar

2024 Quality Reference Guide

Learn the latest specifications for HEDIS®, CMS Part D, CAHPS® and HOS quality measures, including how to report data and billing codes.

Get the guide 2024 Quality Reference Guide

Happening now: Medicaid and CHIP eligibility reviews

For more information, visit

Get the details Happening now: Medicaid and CHIP eligibility reviews

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