UHC - December 2021 Monthly Updates and Articles

December 1, 2021

December 2021 policy and protocol updates overview from United Healthcare

Your notice of protocol and policy changes from UnitedHealthcare

Appendix Bulletins

Medical policy updates: December 2021
This month, you’ll find updates for Medicaid, Medicare, Exchange and commercial plans.

Pharmacy updates
This pharmacy bulletin outlines new or revised clinical programs and implementation dates. It’s available online for UnitedHealthcare commercial and UnitedHealthcare Oxford commercial plans.

Prior authorization and notification requirement updatesopen_in_new
We’re making changes to certain advance notification and prior authorization requirements that are available for you in the 2021 Summary of Changesopen_in_new.

Reimbursement policy updates: December 2021
This month, you’ll find updates for Medicaid and commercial plans.

Specialty Medical Injectable Drug program updates: December 2021
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members.

 

Prior Authorization

Radiology prior authorization update delay
Effective March 1, 2022, the updated procedure codesopen_in_new for the radiology prior authorization program for UnitedHealthcare commercial and Exchange plans will go into effect.

New prior authorization requirements for Individual Exchange plans
Starting March 1, 2022, the following clinical categories will require prior authorization for Individual Exchange plans.

Exchange plans: Prior authorization not required for outpatient therapy services
Starting Dec. 1, 2021, UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans, will not require prior authorization for outpatient therapy services (physical, occupational and speech therapy), up to the member’s benefit limit