United Healthcare November 2017 Medical Policy Updates

United Healthcare Medical Policy Updates
United Healthcare Medical Policy Updates

Click here to view the United Healthcare Medical Policy Updates »

 

United Healthcare posts November 2017 Medical Policy Updates:

 

UPDATED

  • Cardiovascular Disease Risk Tests – Effective Jan. 1, 2018
  • Electric Tumor Treatment Field Therapy – Effective Nov. 1, 2017

 

REVISED

  • Attended Polysomnography for Evaluation of Sleep Disorders – Effective Dec. 1, 2017
  • Epiduroscopy, Epidural Lysis of Adhesions and Functional Anesthetic Discography – Effective Jan. 1, 2018
  • Hip Resurfacing and Replacement Surgery (Arthroplasty) – Effective Dec. 1, 2017
  • Vagus Nerve Stimulation – Effective Jan. 1, 2018

 

RETIRED/REPLACED

  • Hip Replacement Surgery (Arthroplasty) – Effective Dec. 1, 2017
  • Lyme Disease – Effective Nov. 1, 2017

 

Medical Benefit Drug Policy Updates

 

NEW

  • Alpha1-Proteinase Inhibitors – Effective Jan. 1, 2018
  • Ilaris® (Canakinumab) – Effective Jan. 1, 2018
  • Review at Launch for New to Market Medications – Effective Jan. 1, 2018

 

REVISED

  • Actemra® (Tocilizumab) Injection for Intravenous Infusion – Effective Dec. 1, 2017
  • Enzyme Replacement Therapy – Effective Dec. 1, 2017
  • Exondys 51™ (Eteplirsen) – Effective Dec. 1, 2017
  • Probuphine® (Buprenorphine) – Effective Dec. 1, 2017
  • Respiratory Interleukins (Cinqair® and Nucala®) – Effective Dec. 1, 2017
  • Xolair® (Omalizumab) – Effective Dec. 1, 2017

Coverage Determination Guideline (CDG) Updates UPDATED · Ambulance Services – Effective Nov. 1, 2017

  • Emergency Health Care Services and Urgent Care Center Services – Effective Nov. 1, 2017
  • Pectus Deformity Repair – Effective Nov. 1, 2017
  • Rhinoplasty and Other Nasal Surgeries – Effective Nov. 1, 2017

 

REVISED

  • Blepharoplasty, Blepharoptosis and Brow Ptosis Repair – Effective Dec. 1, 2017
  • Breast Repair/Reconstruction Not Following Mastectomy – Effective Dec. 1, 2017
  • Breast Reconstruction Post Mastectomy – Effective Dec. 1, 2017
  • Durable Medical Equipment, Orthotics, Ostomy Supplies, Medical Supplies and Repairs/Replacements – Effective Jan. 1, 2018
  • Habilitative Services for Essential Health Groups – Effective Jan. 1, 2018
  • Panniculectomy and Body Contouring Procedures – Effective Nov. 1, 2017
  • Preventive Care Services – Effective Dec. 1, 2017
  • Preventive Care Services – Effective Jan. 1, 2018
  • Rehabilitation Services (Outpatient) – Effective Jan. 1, 2018

 

Utilization Review Guideline (URG) Updates

 

REVISED

  • Site of Service Guidelines for Certain Outpatient Surgical Procedures – Effective Jan. 1, 2018

· Specialty Medication Administration – Site of Care Review

 

Click here to view the United Healthcare Medical Policy Updates »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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