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.

February 17 publication

State news

Louisiana Medicaid: Updates to specialty pharmacy prior authorization requirements
Effective May 1, 2025, for Louisiana Medicaid, we’ll require prior authorization/notification for certain medications.

New Mexico Medicaid: Virtual doula services available
Learn about the virtual doula services available to Turquoise Care patients during the prenatal or postpartum period.

Prior authorization changes

UnitedHealthcare national Gold Card code update
The UnitedHealthcare national Gold Card program code list has been updated effective March 17, 2025. Learn more.

Updated prior authorization requirements for non-invasive prenatal testing
On April 1, we’ll no longer require prior authorizations for non-invasive prenatal testing.

UHC Provider Portal updates

Time’s almost up: Make sign-in updates by March 6 to avoid portal lockout
Update your UHC Provider Portal sign-in methods before March 6.

Help your patients find the care they need 
Learn why it’s important to verify your organization’s provider directory information and where to go to make updates.

Ensure you and all third-party vendors have UnitedHealthcare Provider Portal access 
How to ensure you and third-party vendors have UnitedHealthcare Provider Portal access and why it’s important.

Miscellaneous news

Complete the required MOC training
Complete the required Model of Care training for special needs plans by Dec. 31.

Cancer Guidance Program rounding down dose option
As of March 1, the CGP will allow providers to round down doses of injectable chemotherapy drugs to the nearest vial size.

Avoid claim rejections and denials
Discover what causes the system to reject corrected and duplicate claims — and steps you can take to avoid payment delays.

Invite your patients to participate in the VOICES of Black Women health study
You can help eliminate gaps in health care by inviting eligible patients to participate in the VOICES of Black Women study.

Announcements