What types of insurance policy changes does this tracker cover?

We track billing and reimbursement policy changes from major U.S. health insurance payers including Cigna, UnitedHealthcare, Aetna, Humana, and regional carriers. Changes include prior authorization updates, coverage determinations, CPT/HCPCS code additions and deletions, fee schedule revisions, and plan-type policy modifications.

How often are new policy changes added?

Our scraper runs daily, so most policy changes appear within 24 hours of the payer publishing them. Each entry shows the date we first identified the change alongside any stated effective date.

Can I filter changes by my specialty or state?

Yes. Use the provider hub, specialty hub, state hub, or billing code hub to narrow the feed to changes that affect your practice. You can also create a free saved search to receive daily email alerts for exactly your filters.

Are historical policy changes available?

Yes. Use the per-year archive links to browse changes by calendar year, or use the pagination below to scroll back through all tracked changes in chronological order.

All Insurance Policy Changes

Real-time index of every insurance policy change we track, across all payers, specialties, states, and plan types. Each entry is AI-summarized and tagged with impact level so you can triage at a glance. New entries are added daily as payers publish updates.

Medium impact
Justice-Involved (JI) Reentry Initiative: Telecommunications Modifier GQ is Reimbursable
Medi-Cal·Effective Oct 1, 2024
Medi-Cal now reimburses modifier GQ (asynchronous telecommunications/store-and-forward) for Justice-Involved (JI) reentry services provided by embedded and in-reach providers, including FQHCs and RHCs. This applies retroactively to October 1, 2024, and includes automatic reprocessing of previously denied claims.
Medium impact
Justice-Involved (JI) Reentry Initiative: Provider Types Updated for General and Care Management Services
Medi-Cal·Effective Oct 1, 2024
The Justice-Involved Reentry Initiative has updated which provider types can deliver general and care management services to justice-involved individuals in Medi-Cal. Several provider types including community clinics, optometrists, and pharmacists have been added, while others like physical therapists, occupational therapists, and speech therapists have been removed from eligibility.
Low impact
August 2026 Medi-Cal In-Person Training Event
Medi-Cal·Effective Aug 11, 2026
Medi-Cal is hosting a free in-person training event on August 11, 2026, in Santa Barbara offering billing courses and individual claims assistance. Registration is required by August 10, 2026, through the Medi-Cal Learning Portal.
Medium impact
New Requirement for Provider Verification in Telephone Service Center
Medi-Cal·Effective Aug 1, 2026
Starting August 1, 2026, providers calling the Telephone Service Center will need to verify their identity using their most recent checkwrite amount instead of previous verification methods. This permanent security enhancement affects all provider interactions requiring verification when contacting support.
Medium impact
[Georgia] Policy Updates January 2025
CareSource·Effective Jan 1, 2025
This is a Georgia Medicaid policy update for January 2025. Without access to the detailed policy content, only the summary is available, indicating changes to Georgia Medicaid medical policies that may affect billing and coverage requirements.
Low impact
[Georgia] Policy Updates February 2025
CareSource·Identified Jun 13, 2026
This appears to be a Georgia-specific CareSource policy update for February 2025, but the provided content only contains a title with no specific policy details or changes described.
Medium impact
[Ohio] Pharmacy Policy Updates April 2025
CareSource·Effective Apr 1, 2025
CareSource has updated their pharmacy policy for Ohio effective April 2025. The policy document contains changes to pharmaceutical coverage, formulary, or prior authorization requirements that will affect prescription-related billing and patient care.
Medium impact
[Georgia] Policy Updates August 2025
CareSource·Identified Jun 13, 2026
This appears to be a Georgia-specific CareSource policy update for August 2025, but the content summary provided is too limited to determine specific changes. The policy is very recent (1 day old) and likely contains important updates for CareSource members in Georgia.
Medium impact
[Georgia] September 2025 Policy Updates
CareSource·Effective Sep 1, 2025
This is a Georgia-specific CareSource policy update for September 2025, but the provided summary lacks specific details about what changes are being implemented. The content appears to be a summary-only document requiring review of the full policy for actionable details.
Medium impact
[Georgia] Policy Updates December 2025
CareSource·Identified Jun 13, 2026
This appears to be a Georgia-specific CareSource policy update for December 2025, but the content provided is only a title without specific policy details. The actual policy changes cannot be determined from the summary-only information provided.
Medium impact
[Georgia] Policy Updates December 2025
CareSource·Identified Jun 13, 2026
CareSource Georgia issued December 2025 policy updates for their Medicaid managed care network. Without access to the full document content, specific changes cannot be determined, but this represents the most current policy guidance for Georgia CareSource Medicaid providers.
Medium impact
[Georgia] Policy Updates - January 2026
CareSource·Effective Jan 1, 2026
CareSource has released January 2026 policy updates for Georgia providers. Without access to the full policy document content, the specific changes and their implications for billing teams cannot be determined from the summary-only information provided.
Medium impact
[Georgia] May 2026 Policy Updates
CareSource·Effective May 1, 2026
This is a Georgia-specific medical policy update for CareSource Medicaid managed care plans effective May 2026. The document appears to be a network notification containing multiple policy changes, but specific details are not available from the summary-only content source.
Medium impact
[Ohio] June 2026 Policy Updates
CareSource·Effective Jun 1, 2026
This appears to be a June 2026 policy update notification for Ohio Medicaid from CareSource, but the content details are not available in the summary provided. Without specific policy content, the billing team should access the full document to understand what changes are being implemented.
Medium impact
[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers
CareSource·Identified Jun 13, 2026
Ohio Administrative Code Rule 5160-1-17.9 updates requirements for ordering, referring and prescribing providers, focusing on NPI requirements for network providers. This appears to be related to CareSource Ohio Medicaid managed care provider network notifications for 2026.
Low impact
[Ohio] Remittance Advice Service Date Correction
CareSource·Identified Jun 13, 2026
CareSource has issued a correction regarding service dates on remittance advice documents for Ohio providers. This appears to be an administrative correction to fix service date reporting errors on remittance advice statements.
Medium impact
[Ohio] Prior Authorization Requirement Update
CareSource·Identified Jun 13, 2026
CareSource Ohio Medicaid has updated prior authorization requirements for Q1, affecting specific medical codes and procedures. This is a quarterly update that modifies which services require prior approval before treatment.
High impact
[Ohio] Prior Authorization Requirement Update
CareSource·Identified Jun 13, 2026
CareSource has updated prior authorization requirements for Ohio Medicaid members, introducing new quarterly codes that require prior approval. This affects billing workflow and claim submission processes for providers serving Ohio Medicaid patients.
Medium impact
[Ohio] Transition of DentaQuest and SkyGen to Delta Dental
CareSource·Identified Jun 13, 2026
DentaQuest and SkyGen dental networks are transitioning to Delta Dental for Ohio CareSource Medicaid members. Billing teams should verify the new Delta Dental network status for dental claims processing.
High impact
[Ohio] Prior Authorization Requirement Update
CareSource·Identified Jun 13, 2026
CareSource has updated their prior authorization requirements for Q4 2024, affecting specific medical codes and procedures. This policy change modifies which services require pre-approval before treatment can be provided to CareSource members.
Medium impact
[Ohio] Hospice Per Diem Billing
CareSource·Identified Jun 13, 2026
CareSource Ohio has issued a policy notification regarding hospice per diem billing procedures. This appears to be a clarification or update to existing hospice billing requirements that may affect how hospice services are billed and reimbursed.
Medium impact
[Ohio] Prior Authorization Requirement Update
CareSource·Effective Feb 1, 2026
CareSource Ohio Medicaid has updated prior authorization requirements for skin substitute therapy services, adding new billing codes and revisions effective February 2026. Medical billing teams must update their authorization workflows for these specific dermatology and wound care procedures.
Medium impact
[Ohio] Level of Care and Prior Authorization Requirements for Medicaid Covered Nursing Facility (NF) Stays
CareSource·Identified Jun 13, 2026
CareSource Ohio Medicaid now requires prior authorization and specific level of care documentation for nursing facility admissions. This affects providers referring patients to nursing facilities under Ohio Medicaid coverage.
Medium impact
[Ohio] Dates Announced: ODM to Roll Out EVV Claims Processing Changes in Seven Phases
CareSource·Identified Jun 13, 2026
Ohio Department of Medicaid (ODM) is implementing Electronic Visit Verification (EVV) claims processing changes in seven phases. This affects how EVV-related claims will be processed and may impact billing workflows for providers serving Medicaid patients in Ohio.
Medium impact
[Ohio] Prior Authorization Requirement Update
CareSource·Identified Jun 13, 2026
CareSource Ohio Medicaid has updated prior authorization requirements for skin substitution therapy, adding new billing codes to their authorization process. This affects providers who perform wound care and skin substitute procedures for Medicaid patients.

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Archive by year

2023 2024 2025 2026

Justice-Involved (JI) Reentry Initiative: Telecommunications Modifier GQ is Reimbursable

Justice-Involved (JI) Reentry Initiative: Provider Types Updated for General and Care Management Services

August 2026 Medi-Cal In-Person Training Event

New Requirement for Provider Verification in Telephone Service Center

[Georgia] Policy Updates January 2025

[Georgia] Policy Updates February 2025

[Ohio] Pharmacy Policy Updates April 2025

[Georgia] Policy Updates August 2025

[Georgia] September 2025 Policy Updates

[Georgia] Policy Updates December 2025

[Georgia] Policy Updates December 2025

[Georgia] Policy Updates - January 2026

[Georgia] May 2026 Policy Updates

[Ohio] June 2026 Policy Updates

[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers

[Ohio] Remittance Advice Service Date Correction

[Ohio] Prior Authorization Requirement Update

[Ohio] Prior Authorization Requirement Update

[Ohio] Transition of DentaQuest and SkyGen to Delta Dental

[Ohio] Prior Authorization Requirement Update

[Ohio] Hospice Per Diem Billing

[Ohio] Prior Authorization Requirement Update

[Ohio] Level of Care and Prior Authorization Requirements for Medicaid Covered Nursing Facility (NF) Stays

[Ohio] Dates Announced: ODM to Roll Out EVV Claims Processing Changes in Seven Phases

[Ohio] Prior Authorization Requirement Update