July monthly overview

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

July 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for July 2024 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

Massachusetts Medicaid: Use appropriate billing codes for faster DME claims processing
Correct billing code information for UnitedHealthcare Community Plan of Massachusetts plan members.

Michigan: Prior authorization updates for provider administered medications 
Starting Oct. 1, 2024, we’ll require prior authorization for some provider administered medications in Michigan.

Nebraska Medicaid: Explore training sessions to stay up to date on topics important to you
Explore available training to help you stay up to date on topics that are important to your practice.

Home health and private duty nursing services prior authorization process
Home health and private duty nursing service prior authorization requests are assessed based on medical necessity and more.

Virgin Islands: Benefit update for certain Medicare Advantage plan members
Effective June 1, 2024, clinical laboratory services will no longer apply to a member’s annual deductible. Learn more.

Prior authorization updates

New prior authorization requirements for CGMs
As of Sept. 1, we’re making updates to continuous glucose monitor coverage for UnitedHealthcare Medicare Advantage plans.

Improvements to prior authorization process for sacral nerve stimulation for urinary and fecal indications
Starting Oct. 1, we’re improving the prior authorization process for SNS for urinary and fecal indications.

Updates to oncology and hematology prior authorization codes for many plans
Starting Oct. 1, 2024, we’ll require prior authorization for diagnosis of oncologic or hematologic conditions.

New online utilization management requirement 
You will be required to submit utilization management requests online for patients delegated to Optum Health Networks.

July 2024 Preferred Lab Network updates

July 2024 Preferred Lab Network list is now available
View the Preferred Lab Network lists for UnitedHealthcare coverage plans, which have been updated as of July 2024.

Update your My Practice Profile

Add your merchant ID in My Practice Profile
Help ensure seamless payments with your unique merchant ID for the UnitedHealthcare Care Cash program.

Federal audit outreach for commercial plans

Annual federal audit of commercial plans 
UnitedHealthcare commercial plan providers may be selected to provide documentation for the HHS annual RADV audit program.

MOC training for special needs plans

Complete special needs plan MOC training by Dec. 31
Complete the CMS mandated training for SNPs and out-of-network providers who routinely see SNP members by Dec. 31.

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