September monthly overview

Network News is published monthly. See updates below.

September 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for September 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: Consider OB Homecare for hypertensive pregnancy disorders
OB Homecare supports members experiencing hypertensive pregnancy disorders and those at risk for developing preeclampsia.

New Jersey Medicaid: Prepare for medical record reviews
Selected providers may be asked to submit records for annual quality audits.

New Mexico 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.

New York Medicaid: Change to Direct Home Care Worker claims
Effective Oct. 1, 2026, changes will be made to how claims are submitted for all Direct Home Care Worker claims.

New York Medicaid: Codes added to Non-Covered Code List
Starting Dec. 1, 2026, physical and occupational therapy evaluation codes 97161-97168 will no longer be covered.

North Carolina Medicaid: Appropriate use of the CR modifier
The CR modifier isn’t billable outside of federal- or state-declared emergencies. Ensure you’re using it correctly.

North Carolina Medicaid: Don't delay well-child visits
Well-child and well-care visits can be completed when due without waiting for a birthday or 365-day interval.

Texas Medicaid: Register for a long-term services and support town hall 
Register for one of our fall UnitedHealthcare Community Plan of Texas town hall events to learn about LTSS.

Prior authorization

Advance notification ending for select GI endoscopy services
On Oct. 1, 2026, we won’t require advance notification for certain GI services for UnitedHealthcare commercial plan members.

Check out the latest Prior Authorization tool enhancements
Learn how we’ve made it easier for providers to complete prior authorization tasks digitally.

New policy and prior auth requirement for select embolization procedures
On Dec. 1, 2026, our new policy will evaluate coverage criteria for select vascular embolization procedures.

We’re reducing prior authorizations by 30%
On Oct. 1, 2026, we’re eliminating 30% of prior authorization requirements for most UnitedHealthcare plans.

Health plan updates

Hereditary cancer testing policy reminder
Coverage criteria reminder of the hereditary cancer genetic testing medical policy.

Medicare GLP-1 Bridge program: What prescribers need to know
Learn how the Medicare GLP-1 Bridge program works and what you need to do when prescribing.

Medicare: Reminder to send us your annual interim rate letter
CMS updates rates annually for providers in certain types of hospitals and facilities. See what you need to do.

Protect your practice: Help patients avoid a lapse in Medicaid coverage
Remind your Medicaid patients to complete their redetermination packets so they don’t lose coverage.

Digital enhancements

Now you can identify Optum Care delegated claims online
Get alerts for delegated claims managed by Optum Care. View claim information by selecting the Optum Care payer ID.

Manage UHC Provider Portal tool access more efficiently
New Request Tool Access feature makes it easier to request and manage digital tool access.

Education and training

Hispanic Heritage Month spotlight: Advancing cancer screening awareness
Promote cancer prevention during Hispanic Heritage Month with culturally resources to support cancer screening conversations.

Announcements