October monthly overview
Network News is published monthly. See updates below.
October 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for October 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
Florida Medicaid: Prepare for EPNA audits
Prepare for EPNA calls and visits by reviewing appointment access, Medicaid participation and directory accuracy.
Indiana Medicaid: Earn incentives as a Hoosier Care Connect provider
You can earn incentives by helping us learn more about our members and completing wellness visits.
Indiana Medicaid: Incentives for Indiana PathWays for Aging providers
You can earn incentives by helping us learn more about our members and completing wellness visits.
Massachusetts providers: Taxonomy and ZIP code requirements for claims
Claims submitted with a missing or incorrect taxonomy code and/or ZIP code will be rejected or denied.
Michigan Medicaid: Paper submissions no longer accepted
Health care professionals are required to submit Medicaid post-service appeals electronically in Michigan.
Michigan: The MCT2D CGM prior auth bypass will end on Jan. 1
On Jan. 1, 2027, the MCT2D prior auth bypass pilot program for continuous glucose monitors will end.
New Mexico Medicaid: Retroactive GRT reimbursements for eligible providers
Starting in October, providers whose claims were underpaid will begin to receive retroactive GRT reimbursements.
New York Medicaid: New postpartum home visit requirements
Arrange initial postpartum home visits for eligible UnitedHealthcare Community Plan of New York members.
New York State Medicaid: Provider revalidation process reminder
Review the updated revalidation schedule and online submission requirements.
Ohio Medicaid: Include ORP NPI to avoid denials
Starting Jan. 1, 2027, federal ORP regulation requires claims for items and services to include an NPI.
Prior authorization
New prior authorization reductions for members under 18
On Dec. 1, 2026, we’ll be reducing prior authorizations for members under the age of 18.
Medicaid: Prior auth reduction efforts expand to more states
Prior authorization reductions expand to more states. View the code list and changes effective Nov. 1.
Medicare: Updated Part B step therapy prior authorization requirements
Starting Jan. 1, 2027, additional medications will require prior authorization as part of the Part B Step Therapy Program.
New AMA issued genetic and molecular prior auth requirements
The AMA issues new genetic and molecular codes every quarter, some of which will be added to the program for management.
New oncology prior authorization code updates
Effective Jan. 1, 2027, prior authorization will be required for certain colony stimulating factor medication HCPCS codes.
Health plan updates
2027 Medicare Advantage service area changes
Learn about changes to UnitedHealthcare Medicare Advantage service areas effective Jan. 1, 2027.
Choice Plus network is expanding
1978 Retired Construction Workers Benefit Trust members have access to the Choice Plus network on Sept. 1, 2026.
Individual Exchange plan PDL updates on Jan. 1, 2027
On Jan. 1, 2027, we’re making changes to the prescription drug lists for UnitedHealthcare Individual Exchange plans.
New UnitedHealthcare Individual Exchange plan information for 2027
View the new UnitedHealthcare Individual Exchange plans for 2027 with additional expansion areas.
Medicaid updates
New federal Medicaid requirements for expansion members
Understand upcoming Medicaid eligibility changes and how to support impacted members.
Colorado and Missouri Medicaid: Paper submissions no longer accepted
Health care professionals are required to submit Medicaid post-service appeals electronically in Colorado and Missouri.
Medicaid: Paper submissions no longer accepted
Health care professionals are required to submit Medicaid post-service appeals electronically in HI, NM, RI and WI.
Tell us how we’re doing: Satisfaction survey is live
Share feedback on claims, denials and tools. Just a few minutes can drive 2027 improvements.
Education and training
Disability Awareness Month: Advancing inclusive care for neurodiverse patients
This Disability Awareness Month, take our ADA compliance course to help support equitable and inclusive care.
Other
New Payment Summary reports for daily and monthly reconciliation
Get a consolidated view of UnitedHealthcare payments based on your payment preference settings.
Announcements
Tennessee Medicaid: Q2 Insights newsletter
Learn about safe adolescent antipsychotic use, the importance of EPSDT screenings, adult preventive care and more.
New Mexico providers: Avoid denials for incorrect taxonomy
Ensure claims include accurate information before submitting.
