All Insurance Policy Changes (Page 1307)

Continuing from page 1306. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

High impact
Surgery of the Knee
UnitedHealthcare·Effective Jun 1, 2026
UnitedHealthcare has updated their Surgery of the Knee medical policy effective June 1, 2026. This is a very recent policy change that may affect coverage criteria, prior authorization requirements, or billing guidelines for knee surgical procedures.
Medium impact
Preventive Care Services
UnitedHealthcare·Effective Jul 1, 2026
The preventive care services medical policy has been revised with an effective date of July 1, 2026. However, the specific details of what changed in the policy are not provided in the available content, making it impossible to determine the exact billing implications.
Medium impact
Minimally Invasive Procedures for the Treatment of Upper Gastrointestinal Diseases
UnitedHealthcare·Effective Aug 1, 2026
This policy update revises coverage guidelines for minimally invasive procedures used to treat upper gastrointestinal diseases. The changes will take effect August 1, 2026, potentially affecting coverage criteria, prior authorization requirements, or billing procedures for GI-related minimally invasive treatments.
Medium impact
Manipulative Therapy
UnitedHealthcare·Effective Jun 1, 2026
This is a policy update regarding Manipulative Therapy effective June 1, 2026. However, the provided policy content only contains header information without the actual policy details, making it impossible to determine specific changes to billing, coverage, or authorization requirements.
Medium impact
Infertility Diagnosis, Treatment, and Fertility Preservation
UnitedHealthcare·Effective Jun 1, 2026
UnitedHealthcare updated their medical policy for infertility diagnosis, treatment, and fertility preservation services effective June 1, 2026. This policy change affects coverage criteria and potentially billing requirements for fertility-related procedures and treatments.
Medium impact
Gastrointestinal Disorders Diagnostic Procedures
UnitedHealthcare·Effective Jun 1, 2026
UnitedHealthcare has updated their medical policy for Gastrointestinal Disorders Diagnostic Procedures effective June 1, 2026. This policy change affects billing and coverage requirements for GI diagnostic procedures, though specific details about code changes, prior authorization requirements, or coverage modifications are not provided in the available policy excerpt.
Medium impact
Epidural Steroid Injections for Spinal Pain
UnitedHealthcare·Effective Jun 1, 2026
UnitedHealthcare has updated their medical policy for epidural steroid injections for spinal pain, effective June 1, 2026. This policy change may affect coverage criteria, prior authorization requirements, or documentation standards for these procedures commonly performed in pain management and orthopedic practices.
Medium impact
Cosmetic and Reconstructive Procedures
UnitedHealthcare·Effective Jun 1, 2026
UHC updated their cosmetic and reconstructive procedures policy effective June 1, 2026. This policy change affects coverage determinations and billing requirements for procedures that may be considered cosmetic versus medically necessary reconstructive surgery.
Medium impact
Chromosome Microarray Testing (Non-Oncology Conditions)
UnitedHealthcare·Effective Jun 1, 2026
Updated medical policy for Chromosome Microarray Testing for non-oncology conditions, effective June 1, 2026. This policy update affects coverage criteria and billing requirements for genetic testing services used in diagnosing developmental delays, intellectual disabilities, and congenital anomalies.
Low impact
Category III Codes
UnitedHealthcare·Effective Jul 1, 2026
This policy update addresses Category III codes, which are temporary CPT codes for emerging technologies and procedures. The policy content provided is incomplete, showing only header information without specific changes or requirements.
Medium impact
Beds and Mattresses
UnitedHealthcare·Effective Jul 1, 2026
This is a revised medical policy for beds and mattresses effective July 1, 2026. However, the provided content only shows header information without the actual policy details, making it impossible to determine specific changes to coverage, billing codes, or requirements.
Medium impact
Ambulance Services
UnitedHealthcare·Effective Jun 1, 2026
This is a medical policy update bulletin for ambulance services effective June 1, 2026. However, the provided content only includes header information without specific policy details or changes.
Medium impact
[Georgia] June 2026 Provider Newsletter
Anthem BCBS·Identified Jun 2, 2026
This June 2026 Georgia provider newsletter from Anthem announces multiple policy updates effective at different dates, including prior authorization requirement changes for parenteral nutrition codes (effective July 1, 2026), additional precertification changes (effective September 1, 2026), clinical criteria updates (effective June 1, 2026), and a reminder about accurate billing charges and units on professional claims (effective July 17, 2026). Specific billing code details and clinical criteria are referenced but not fully detailed in this newsletter index.
High impact
[Ohio] June 2026 Provider Newsletter
Anthem BCBS·Identified Jun 2, 2026
This June 2026 Ohio provider newsletter from Anthem consolidates multiple policy updates across Commercial, Medicare Advantage, Medicaid, and MyCare Ohio plans, including changes to prior authorization requirements for parenteral nutrition and other services, medical policy updates, E/M coding guidance, and operational changes effective between July 2026 and September 2026. Billing teams must review multiple effective dates and implement corresponding workflow changes to avoid claim denials.
High impact
[New York] June 2026 Provider Newsletter
Anthem BCBS·Effective Jul 1, 2026
Anthem's June 2026 New York newsletter consolidates multiple policy updates effective across July-September 2026, including prior authorization requirement changes for parenteral nutrition codes (Medicare Advantage effective July 1), new prior auth changes for Medicare Advantage and Medicaid (effective September 1), pharmacy prior authorization and step therapy updates for medical benefit medications (Medicaid effective July 1), clinical criteria updates, and administrative changes to billing accuracy requirements (effective July 17, 2026 across all plans). Billing teams must systematically update systems and workflows for each affected plan type and effective date.
High impact
[California] June 2026 Provider Newsletter
Anthem BCBS·Effective Jun 1, 2026
This is a comprehensive June 2026 provider newsletter from Anthem containing multiple policy updates across administrative, clinical, and prior authorization areas. Key changes include: (1) Direct HMO renamed to Independent FFS Physicians effective January 1, 2026; (2) Weekly authorization and denial log submission required for HMO risk providers effective July 15, 2026; (3) Multiple prior authorization requirement changes for parenteral nutrition codes, various services, and pharmacy effective July 1 through September 1, 2026; (4) Clinical criteria updates effective June 1, August 18, and September 1, 2026; (5) Digital solutions enhancements including online peer-to-peer conversations and billing accuracy reminders effective mid-July and July 17, 2026.
High impact
[New York] 2027 maternity care coding restructuring allows for more detailed reporting
Anthem BCBS·Effective Jan 1, 2027
Effective January 1, 2027, New York Medicaid is restructuring maternity care coding from legacy global codes to granular phase-based reporting across four phases: antepartum (E/M codes per encounter), labor management (daily reporting with initial/subsequent day levels), delivery (streamlined codes by type with new laceration/episiotomy codes), and postpartum (E/M codes per encounter). This requires significant billing workflow changes for all providers billing maternity services to NYS Medicaid members.
High impact
We’re making updates to help you identify and resolve certain electronic claim submission errors more quickly
Cigna·Effective Jul 1, 2026
Cigna Healthcare is implementing real-time claim rejection for EDI submissions with unacceptable primary diagnosis codes starting July 1, 2026. Claims with invalid primary diagnoses will be rejected at submission (not after processing) and returned with specific error codes A7 and 255 for immediate correction.
Low impact
The Cigna Group appoints Brian Evanko Chief Executive Officer
Cigna·Effective Jul 1, 2026
The Cigna Group announced that Brian Evanko will become CEO effective July 1, 2026, replacing David M. Cordani who will transition to executive chair. This is a leadership announcement and does not affect billing procedures, codes, or payment policies.
Low impact
A personalized approach, biologic utilization, and new management strategies for treating severe asthma
Cigna·Identified Jun 2, 2026
Cigna Healthcare has published comprehensive coverage policies for seven FDA-approved biologic therapies for treating severe asthma, including the newly approved EXDENSUR. This is an informational update outlining available biologics and their coverage policies rather than announcing specific billing changes.
Medium impact
We’re Reviewing Prior Authorization Exemptions
BCBS Texas·Effective Jun 1, 2026
Blue Cross Blue Shield of Texas is reviewing providers for new prior authorization exemptions and reviewing previously rescinded exemptions for certain healthcare services. Providers who had at least five prior authorizations during the review period will qualify for consideration.
Medium impact
Enhanced Prepay Review of Commercial Sepsis Claims to Begin
BCBS Texas·Effective Sep 1, 2026
Effective September 1, 2026, Blue Cross Blue Shield of Texas will implement enhanced prepay review using Machinify for commercial sepsis diagnosis-related group claims to ensure proper coding and medical necessity. This will add an additional review step for sepsis claims before payment but should not increase response times.
Medium impact
Prior Authorization Changes for Some Government Program Members
BCBS Texas·Effective Aug 1, 2026
Blue Cross Blue Shield of Texas is implementing new prior authorization requirements for government program members. Drug therapy codes for Medicaid members will require prior authorization starting August 1, 2026, and select Proton Beam codes for Medicare Advantage members will require prior authorization starting October 1, 2026.
Medium impact
New Mexico Medicaid: Updated payment policy for acute care readmissions
UnitedHealthcare·Identified Jun 2, 2026
New Mexico Medicaid has updated their payment policy for acute care readmissions, establishing new review processes and payment guidelines for hospital readmissions within specific timeframes.
High impact
New Mexico Medicaid: State enrollment is required for claim payment
UnitedHealthcare·Effective Jul 1, 2026
Effective July 1, 2026, New Mexico Medicaid will deny claims when attending, referring, ordering, and prescribing providers are not enrolled with the state Medicaid program. All providers and pharmacists must register at yes.nm.gov before the effective date to avoid claim denials.

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Archive by year

2023 2024 2025 2026

Surgery of the Knee

Preventive Care Services

Minimally Invasive Procedures for the Treatment of Upper Gastrointestinal Diseases

Manipulative Therapy

Infertility Diagnosis, Treatment, and Fertility Preservation

Gastrointestinal Disorders Diagnostic Procedures

Epidural Steroid Injections for Spinal Pain

Cosmetic and Reconstructive Procedures

Chromosome Microarray Testing (Non-Oncology Conditions)

Category III Codes

Beds and Mattresses

Ambulance Services

[Georgia] June 2026 Provider Newsletter

[Ohio] June 2026 Provider Newsletter

[New York] June 2026 Provider Newsletter

[California] June 2026 Provider Newsletter

[New York] 2027 maternity care coding restructuring allows for more detailed reporting

We’re making updates to help you identify and resolve certain electronic claim submission errors more quickly

The Cigna Group appoints Brian Evanko Chief Executive Officer

A personalized approach, biologic utilization, and new management strategies for treating severe asthma

We’re Reviewing Prior Authorization Exemptions

Enhanced Prepay Review of Commercial Sepsis Claims to Begin

Prior Authorization Changes for Some Government Program Members

New Mexico Medicaid: Updated payment policy for acute care readmissions

New Mexico Medicaid: State enrollment is required for claim payment

We’re Reviewing Prior Authorization Exemptions