September monthly overview
Network News is published once a month. See updates below.
September 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for September 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
California: New screening requirements for pregnant and postpartum patients
View the state’s new requirements for mental health screenings for pregnant and postpartum patients.
California: Verify/update directory information to avoid payment delays
Please confirm or update your demographic data to avoid payment delays, directory removal.
Hawaii Medicaid: Get ready for paperless claim-related documents and submissions starting Oct. 3
Starting Oct. 3, several documents and submissions are going digital only.
Hawaii Medicaid: Support patients by completing a depression screening
Use the depression screening tool to identify and manage depression for both adults and children.
Kansas and Virginia prior authorization for outpatient therapies: Medicaid
Prior authorization requirements for outpatient PT, OT, ST are changing for specific plan members in Kansas, North Carolina and Virginia on Nov. 1
Kentucky Medicaid: VCP statements are going paperless Oct. 3
Starting Oct. 3, 2025, we’ll no longer mail VCP statements to Kentucky.
Maryland Medicaid: Get ready for paperless VCP statements and claim letters starting Oct. 3
Starting Oct. 3, VCP statements and claim letters are going digital only.
New Jersey: Submit your medical records documentation for annual review
Annual medical record reviews will soon be underway with UnitedHealthcare Community Plan of New Jersey care providers.
North Carolina Medicaid: Prior authorization updates for specialty pharmacy medications
As of Dec. 1, 2025, we’ll require prior authorization for some specialty medications for North Carolina Medicaid.
North Carolina Medicaid: Changes to prior authorization for outpatient therapies
Prior authorization requirements for outpatient PT, OT, ST are changing for specific plan members in Kansas, North Carolina and Virginia on Nov. 1
Texas Medicaid: Register for a long-term services and supports town hall
Register for one of our fall UnitedHealthcare Community Plan of Texas town hall events to learn about LTSS.
Washington Medicaid: SDOH screenings made easier with Epic
You can complete social drivers of health screenings within your Epic workflow.
Digital tools and updates
See how we’ve streamlined the prior authorization inquiry process
Updates to our Prior Authorization and Notification tool help improve the prior authorization inquiry process
Want more speed and accuracy in your workflow? Try our new supercharged APIs
Our supercharged digital connectors simplify your workflow and help prevent delays.
Medicare plan news
AARP Medicare Supplement claims address change
Use the new AARP Medicare Supplement claims mailing address to avoid claims processing delays
Medicare: Reminder to send us your annual interim rate letter
CMS updates rates annually for providers in certain types of hospitals and facilities. See what you need to do.
Medicare updates: Prolia and Xgeva replaced by biosimilars
On Sept. 1, 2025, Prolia and Xgeva are replaced by 2 interchangeable biosimilar products for Medicare plans.
Training and Education updates
Does your practice provide SNP care? Complete the required training
Complete the annual Model of Care training for special needs plans by Dec. 31.
Hispanic Heritage Month: Addressing social drivers of health
Help patients in diverse communities connect with the resources they need for better well-being. Follow these guidelines.
Elevate your immunization strategy with these standards and best practices
Explore the Immunization Best Practices self-paced guide to help your practice identify opportunities and build strategies.
Check your Gold Card program eligibility
You can verify your Gold Card program status by logging in to the UnitedHealthcare Provider Portal.
Tennessee UnitedHealthcare Insights: Your quarter 3 update
Get the latest updates from UnitedHealthcare Community Plan of Tennessee.
Submit claim reconsiderations and appeals electronically
Submission process now takes less time and provides easier access to the information you need.
