October monthly overview
Network News is published twice a month. See updates below.
October 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for October 2023 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
New Jersey: Help raise Medicaid redetermination awareness for your patients
Your New Jersey Medicaid patients may need to renew their coverage. If not, they could lose their eligibility.
New Jersey 21st Century Cures Act requirement
We are denying claims if you are not compliant with the 21st Century Cures Act enrollment requirement.
Texas: LTSS rate changes for STAR Kids, STAR+PLUS
Effective Sept. 1, 2023, bill long-term services and supports (LTSS) according to the updated HHSC rate charts.
Prior authorization updates
Medicare: Part B step therapy prior authorization requirements
For dates of service starting Jan. 1, 2024, prior authorization is required for Part B step therapy program medications.
Submit oral chemotherapeutic prior authorizations to CGP
Starting Nov. 1, 2023, prior authorizations for oral chemotherapeutics will only be accepted through the Cancer Guidance Program.
Prescription drug notices
Empire Plan includes Excelsior and Student Employee Health Plans
In-network for The Empire Plan means in-network for The Excelsior Plan and Student Employee Health Plan (SEHP).
New 2024 Individual Exchange plans and prior authorization information
On Jan. 1, 2024, we'll launch Individual Exchange plans in 4 new states. Learn more.
October 19 publication
State News
Help ensure covered lab services, refer patients to Labcorp
Help prevent claim rejections for UnitedHealthcare Community Plan members by referring them to Labcorp.
Overpayment letters going digital Nov. 3
Beginning Nov. 3, we’ll no longer mail overpayment letters sent directly by UnitedHealthcare* for UnitedHealthcare Community Plan (Medicaid) in Arizona.
Arizona offering new health care scholarship opportunities
AHCCCS is offering 2 new scholarships for students pursuing a career in behavioral health and home and community-based services.
Missouri: New webinar series on MO HealthNet programs
Mark your calendar to learn more about how MO HealthNet programs can help support your patients.
UnitedHealthcare Community Plan of North Carolina outpatient specialty claims
When you submit an outpatient specialty therapy claim, you must complete the Care Provider drop-down field.
Overpayment letters, VCP statements going paperless Nov. 3
Beginning Nov. 3, we’ll no longer mail certain documents to network health care professionals (primary and ancillary) and facilities for UnitedHealthcare Community Plan (Medicaid) in Tennessee.
Plan and program changes
Peoples Health is transitioning to UnitedHealthcare systems
Learn how the upcoming Peoples Health transition will affect processing claims and managing patient information.
FedEx employees will have UnitedHealthcare, Surest and Optum benefits on Jan. 1
FedEx employees will soon have access to UnitedHealthcare, Surest and Optum plans and benefits.
Submit your 2023 diagnostic data for ACA-covered plans
Submit your diagnostic data for patients enrolled in certain small group and individual ACA-covered health plans.
Q4 2023 MA-PCPi program enhancements
Explore temporary enhancements to the Medicare Advantage Primary Care Physician Incentive program for Q4 2023.
You may be in network for some Oxford plan members
Oxford members can access in-network care from UnitedHealthcare Choice Plus or UnitedHealthcare Core Network providers.
Paperless updates
VCP statements going paperless Nov. 3
Beginning Nov. 3, 2023, we’ll no longer mail virtual card payment (VCP) statements to most network medical health care professionals (primary and ancillary) and facilities who receive them in the mail.
Medicaid claim letters are going paperless
Beginning Nov. 3, 2023, we will no longer mail claim letters to most medical network health care professionals and facilities for UnitedHealthcare Community Plans (Medicaid) in Minnesota, New York and North Carolina.
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