03/18/2024

United Healthcare

United Healthcare Managed Care Committee Member

Shelby Jensen, CHONC - Newland Medical Associates

General

We know that providers have been experiencing challenges with medical claims and payments because of the cyber-attack on CHANGE Healthcare on February 21st.  While UnitedHealth Group has issued its own temporary provider assistance fund, CMS had been struggling with whether or not it had the statutory authority to issue accelerated and advanced payments to providers – particularly in Part B. The last time CMS did something similar, it was during the pandemic and the agency had emergency waiver authorities granted under the public health emergency that no longer exists.

This weekend, CMS issued further provider assistance, particularly as it relates to providers in Part B.  The announcement states that in addition to considering applications for accelerated payments for Medicare Part A providers, CMS will now also be considering applications for advance payments for Part B providers. Please see both the CMS fact sheet and statement below.

Fact Sheet 

CMS Statement 

UnitedHealthcare Provider Portal Access Changes

Update your One Healthcare ID to maintain portal access 
You’ll need to update your One Healthcare ID sign-in method soon to maintain access to the UnitedHealthcare Provider Portal.

**This is a big deal. If you use the portal, you will need to update your One Healthcare ID authentication options to retain access. This summer, they will be removing email as a sign-in and recovery option. If authenticator is not an option for your organization, they are working on other solutions to meet people's needs. These options will be coming later in 2024, and details will be added to the above resources when available.

Policy and Protocol Updates

Medical policy updates 
Medical policy updates for March 2024 for the following plans: Medicare, Medicaid, Exchanges, and commercial.

**Certain drugs have had some diagnosis code additions to their policies (i.e. Prolia)

Reimbursement Policy Updates

Reimbursement policy updates 

Specialty Medical Injectable Drug Program Updates

Specialty Medical Injectable Drug program updates 

Pharmacy and Clinical Updates 

Pharmacy and clinical updates 

State News

Elevated lead levels found in applesauce products 
Nationwide recall warns of elevated lead levels in various applesauce products and encourages testing for lead poisoning.

Your network directory information may be inaccurate 
We may contact your practice soon to correct these panel status errors.  

Online Resources

Streamline prior authorizations with our crosswalk 
Use our updated Prior Authorization Crosswalk to help determine next steps.