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February 01, 2026

February monthly overview

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

February 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for February 2026 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 Medicaid: New guidance for early childhood mental health providers
The State of Hawaii Department of Human Services has issued new guidance for QUEST Integration Health Plans.

Idaho Medicaid: New billing updates for diabetes equipment and supplies
On April 1, 2026, the billing of diabetes equipment and supplies will shift from medical to pharmacy benefits.

Choice Plus membership is growing in Illinois, Indiana
Effective Jan. 1, 2026, NECA-IBEW Welfare Trust Fund members have access to the Choice Plus network.

Maryland Medicaid to cover cell and gene therapy for sickle cell disease
Now you can treat members with sickle cell disease through the CMS Cell and Gene Therapy Access Model. Learn more.

Choice Plus membership is growing in Missouri
Effective Jan. 1, 2026, St. Louis Painters Welfare Fund members have access to the Choice Plus network.

New York Medicaid: Dialysis treatment reimbursements include phosphate binders
As of Jan. 1, 2026, the cost of phosphate binders used in APG dialysis sessions is included in the claim reimbursement.


Prior authorization updates

New streamlined radiation therapy prior authorization updates
On Jan. 1, 2026, certain radiation oncology codes will be updated to help simplify prior authorizations.

Updates to the UnitedHealthcare national Gold Card program
The UnitedHealthcare national Gold Card program code list has been updated effective Jan. 1, 2026.


Digital platform updates

Access virtual card payments from members
Health care providers now have more visibility and control over how they receive payments from members.

Feb. 1: Paper submissions are being phased out
Health care professionals are required to submit commercial and Medicare Advantage post-service appeals electronically.


Education and training

Black History Month: Treat chronic kidney disease
Black Americans are at high risk of developing kidney disease. Earn credits while learning how to mitigate CKD progression.

Tennessee Insights: Your quarter 4 update

Get the latest updates from UnitedHealthcare Community Plan of Tennessee.

Read the newsletter Tennessee Insights: Your quarter 4 update
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