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August 01, 2023

August monthly overview

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

August 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for August 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.


Prior authorization reductions

UnitedHealthcare is eliminating Prior Auth requirements for hundreds of procedures beginning Sept. 1
Beginning Sept. 1, 2023, we’re eliminating medical procedure codes that account for 20% of prior authorizations for all plans.


State news

Arizona immunization program re-enrollment 
Primary care providers must re-enroll with the Arizona VFC program before Aug. 31.

Updated requirements for anthropometric and biochemical data
Starting Oct. 1, 2023, you will be required to complete anthropometric and biochemical documentation for WIC participants.

Overpayment letters going digital Sept. 8
On Sept. 8, 2023, we won’t mail overpayment letters to most Arizona Medicaid network health care professionals/facilities.

Colorado: Oncology drug prior authorization update
Starting Nov. 1, 2023, we’ll require prior authorization for chemotherapy drugs received in an outpatient setting.

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.

Nebraska Medicaid: Prior authorization updates for genetic and molecular testing
Effective Oct. 1, 2023, we're updating prior authorization requirements for genetic and molecular testing services.

New Hampshire: New, streamlined referral process 
View our training to see how our new referral process can help you get claims paid quicker.

New Jersey: Coverage reminder for Avastin
UnitedHealthcare Community Plan of New Jersey covers Avastin (bevacizumab) in certain treatment situations.

New York: Required cultural health training by Oct. 1
Improve patient care by completing our required cultural health training by Oct. 1.

North Carolina home health care EVV training
You’re required to use electronic visit verification for home health visits starting on Aug. 1. Here’s how to get training.

Texas: New Trauma Talks course now available
A new behavioral health course is available to help you recognize trauma’s effects on children and help them heal.


Digital updates

UnitedHealthcare Provider Portal enhancements for Surest benefit plans
Several new features are available in the UnitedHealthcare Provider Portal for Surest benefit plans.

VCP statements going paperless Nov. 3
Starting Nov. 3, 2023, we’ll no longer mail VCP statements to MI, MN, MO, NC, OH, RI and TX.

Medicaid claim letters are going paperless
As of Nov. 3, 2023, Medicaid claim letters won’t be mailed in Minnesota, New York and North Carolina.


August 17 publication

State news

Arizona Medicaid: Appeal letters won’t be mailed starting Sept. 8
Starting Sept. 8, 2023, we’ll no longer mail appeal decision letters for most UnitedHealthcare Community Plans (Medicaid) of Arizona.

Maryland: Review changes to biomarker test coverage criteria
Beginning Sept. 1, we’re implementing new coverage criteria for biomarker tests. Learn more about these changes.

Mississippi Medicaid: Several document types won’t be mailed starting Sept. 8
On Sept. 8, some medical claim-related documents for MS Medicaid health care professionals/facilities are going digital.


Plan and process changes

Temporary changes to address oncology drug shortages
We are making changes to help address current oncology drug shortages and minimize care delays.

You’re in network for some Oxford plan members
Members with Oxford plans are in network through either UnitedHealthcare Choice Plus or UnitedHealthcare Core.


Tools and resources

Behavioral health tools for primary care providers
View helpful tools and resources you can use as you care for patients with substance use disorder.


Paperless updates

Coming soon: Medicaid claim letters won’t be mailed
Starting Sept. 8, 2023, Medicaid claim letters won’t be mailed in multiple states.

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