January monthly overview

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

January 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for January 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

Arizona Medicaid: Electronic reconsideration submissions required soon
Health care professionals must submit Medicaid claim reconsideration submissions electronically in Arizona.

Kentucky Medicaid: More UnitedHealthcare members may be coming to your practice
Many Kentucky Medicaid members will be transitioning to UnitedHealthcare on Jan. 1, 2025.

Nebraska Medicaid: Explore training sessions to stay up to date on topics important to you
See information on upcoming training and stay up to date on topics that are important to your practice.

Nebraska: Centralized credentialing available soon
UnitedHealthcare Community Plan of Nebraska will soon offer centralized credentialing processing.

New York Medicaid: Doula Services added to Medicaid Managed Care
UnitedHealthcare Community Plan of New York members soon eligible for doula services during and after pregnancy.

New Jersey Medicaid: Coverage updates for behavioral health services 
Learn about upcoming behavioral health coverage changes for NJ FamilyCare members enrolled in UHC community plans.

Review Texas Medicaid and Healthcare Partnership CPW program changes
As of Dec. 1, 2024, we won’t require prior authorizations for the Texas Medicaid and Healthcare Partnership Children and Pregnant Women program services.

New genetic and molecular codes added to Texas state prior authorization requirements
We’ve added additional genetic and molecular codes to Texas state's prior authorization requirements.

Gain continuing education credits and discover top UTI strategies for your patients 
This activity is provided by Optum Health Education and United Healthcare, Community Health Plan of Texas.

2025 Care Provider Administrative Guide

Your 2025 Care Provider Administrative Guide is ready
View updated 2025 UHC Care Provider Administrative Guide for commercial, Individual Exchange and Medicare Advantage plans.

UHC Provider Portal updates

Avoid UHC Provider Portal lockout: Ensure sign-in includes passkey, authenticator and/or a phone number 
Update UHC Provider Portal sign-in to include passkey, authenticator and/or a phone number by March 6 to avoid lockout.

Plan and program updates

Register certain tests for phase 4 of the DEX Z-Codes
As of Jan. 1, 2025, you can register tests that are in scope for phase 4 of the DEX Z-Codes®.

Explore preferred covered alternatives for recently discontinued AstraZeneca products
AstraZeneca has announced the discontinuation of Bydureon BCise and Byetta. Review preferred covered alternatives.

2025 UnitedHealthcare UCard updates
Review upcoming updates to the UnitedHealthcare UCard for Medicare Advantage patients.

The Empire Plan logos have a new look 
The Empire Plan, administered by UHC on behalf of the State of New York and its related entities, has updated its logos.

January 16 publication

State news

Florida Medicaid: Earn an OBRAF incentive
Learn how you can earn an additional incentive when you complete an obstetrical risk assessment form.

See what’s new: Georgia 2025 provider protocols 
Learn more about Georgia’s advance notice for out-of-network providers, balance billing non-covered services provider protocols.

More Choice Plus plan members may be coming to your practice starting Jan. 1. 
Chicago Graphic Arts Health & Welfare Fund plan members have access to the Choice Plus network on Jan. 1, 2025.

New York Medicaid: Review state compliance program requirements
To receive medical assistance payments or submit claims for care, your New York practice may require a compliance program.

Digital platform updates

Take action by March 6 to avoid portal lockout: Update your sign-in methods
Update UHC Provider Portal sign-in methods to include passkey, authenticator and/or verified phone number by March 6.

SDOH screenings made faster and easier with Epic
You can complete social drivers of health screenings within your Epic workflow.

Health plan changes

Medicare Advantage: Updates to prior authorization requirement for outpatient therapy and chiropractic services 
Medicare Advantage prior authorization requirement for physical, speech and occupational therapy as well as chiropractic services.

New Options PPO members may be coming to your practice starting Jan. 1
Electrical Workers Benefit Trust Fund Local 481 members have access to the Options PPO network on Jan. 1, 2025.

GEHA members transitioned to UMR on Jan. 1
Government Employees Health Association (GEHA) members move to full-service UMR operations.

Maximize your incentives in 2025 with the enhanced MA-PCPi program
The enhanced 2025 Medicare Advantage Primary Care Physician Incentive (MA-PCPi) program has new ways to earn rewards.

Announcements