February monthly overview
Network News is published twice a month. See updates below.
February 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for February 2025 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: Changes to prior authorization process for musculoskeletal surgical procedures, effective May 1
Beginning May 1, 2025, TurningPoint will manage prior authorization requests for musculoskeletal surgical procedures.
Updates to pharmacy prior authorization and step therapy requirements
Effective Jan. 1, 2025, Optum Rx will manage pharmacy prior authorizations and step therapy requests for Golden Rule plans.
More UnitedHealthcare Choice Plus plan members may be coming to your practice
BCTGM Local 53 and Local 2179 UAW Health and Welfare Fund members have access to the Choice Plus network on Jan. 1, 2025.
North Carolina Medicaid: Avoid rejected claims. Include billing taxonomy code and registered NPI.
As of Jan. 9, 2025, all claims must include the taxonomy code and registered NPI upfront to avoid rejection.
Texas Medicaid: State-required medication prior authorization updates
Effective March 1, 2025, we’re updating Texas Medicaid clinical prior authorization criteria for certain medications.
Texas Medicaid: Help avoid pharmacy prior authorization delays
Remember to include all required clinical documentation when submitting a pharmacy prior authorization request.
Digital platform updates
Final notice: Don’t lose access to the portal. Make sign-in updates by March 6.
Update your UnitedHealthcare Provider Portal sign-in by March 6 to avoid lockout.
10 reasons to skip the phone and embrace digital
Get more details about our latest digital tools and portal enhancements.
Plan and policy changes
NexusACO plans will be available to more UnitedHealthcare members in 2025
UnitedHealthcare NexusACO® plans are growing in 2025. Learn more about the benefits and features.
New England Health Care Employees Welfare Fund joins UnitedHealthcare Choice Plus Network
The New England Health Care Employees Welfare Fund members have access to the Choice Plus network on Jan. 1, 2025.
Announcements
Medicare Part D cost and formulary changes
On Jan. 1, Inflation Reduction Act changes, drug cost adjustments and formulary updates took effect for Medicare members.
HouseCalls Documentation folder added to Document Library
You can find Post-Assessment letters in the HouseCalls Documentations folder. Folder only shows if letters are available.
