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March 01, 2025

March monthly overview

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

March 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for March 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.


Network News email cadence change

Network News is going monthly
Starting April 1, 2025, you’ll only receive 1 email per month for Network News updates.


State news

June 6: Several documents going paperless
More letters and reconsiderations, pre-/post-service appeals going digital for Kentucky, Washington, D.C., Medicaid.

Updates to specialty pharmacy prior authorization requirements for UnitedHealthcare Community Plan members in Michigan 
Effective June 1, 2025, for Michigan Medicaid, we’ll require prior authorization/notification for certain medications.

Coordination of benefits reconsideration review 
Email us to review Missouri Medicaid COB reconsiderations.

Full test menu providers available in our Preferred Lab Network 
Our Preferred Lab Network offers full test menu providers, Quest Diagnostics and LabCorp, for UHC Community Plan of NJ.


Prior authorization updates

Home health prior authorization review process no longer required
We won’t require prior authorization or concurrent review processes for some Medicare home health services as of April 1.


Digital enhancements

June 2: Electronic reconsideration and appeal submissions required
Health care professionals must submit Medicaid medical reconsiderations and appeals electronically in FL, NY, OH and RI.

Don’t wait: Submit your saved My Practice Profile changes
Submit saved changes in My Practice Profile within 14 days to avoid losing changes.

How to submit a pre-service appeal
Learn how to submit pre-service appeals electronically.


Miscellaneous news

Ensure uninterrupted patient care: Help your Medicaid patients avoid a lapse in coverage
Remind your Medicaid patients to complete their redetermination packets so they don’t lose coverage.

Improve patient satisfaction through cultural competency
Cultural competency helps build trust in health care and creates a safe environment for multicultural patients. See how.


Announcements

SSI clearinghouse users can send unsolicited attachments electronically

Learn more about EDI 275 transactions, and see the list of clearinghouses that support unsolicited claim attachments.

Get details SSI clearinghouse users can send unsolicited attachments electronically
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