All Insurance Policy Changes (Page 1337)

Continuing from page 1336. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Low impact
Reminder: Public Comment Period for Proposed EVV Rule Updates – Due by May 4
Texas Medicaid·Identified May 5, 2026
Texas Health and Human Services Commission is accepting public comments on proposed updates to Electronic Visit Verification (EVV) rules through May 4, 2026. This is an opportunity for healthcare practices to provide input on proposed regulatory changes that may affect home health and personal care services billing.
Medium impact
Provider Responsibility - Maintaining Records
Texas Medicaid·Identified May 5, 2026
Texas providers must maintain medical records for 7 years after claim submission or until patient turns 21, whichever is later. When contracts expire or terminate, providers must report record storage location and contact information to HHSC contract manager.
Medium impact
FQHC and RHC Home Telemonitoring Providers Must Use Procedure Code S9110 With Modifier U3
Texas Medicaid·Effective Jan 1, 2026
Starting January 1, 2026, FQHCs and RHCs providing home telemonitoring services must use procedure code S9110 with modifier U3 instead of the discontinued code G0511 when billing Texas Medicaid. TMHP will automatically reprocess affected claims and has waived filing and appeal deadlines.
Medium impact
New faxable Residential Prior Authorization Request Form
Cigna·Effective May 4, 2026
Evernorth Behavioral Health now offers a new faxable form option for submitting residential prior authorization requests to reduce administrative burden. Providers can now fax requests to 833.213.9320 using the new Residential Prior Authorization Request Form instead of only calling.
High impact
Changes to Substance Use Disorder (SUD) treatment services
Minnesota Medicaid (MHCP)·Effective Jul 1, 2026
Minnesota is implementing legislative changes to Substance Use Disorder (SUD) treatment services effective July 1, 2026. These changes include new service type descriptions, new billing codes, and new billing procedures for outpatient SUD providers. The changes are pending federal approval and require preparation time before implementation.
High impact
Use modifiers with physical therapy (PT) and occupational therapy (OT) authorizations
Minnesota Medicaid (MHCP)·Identified May 5, 2026
Minnesota Health Care Programs (MHCP) now requires specific modifiers on all physical therapy (PT) and occupational therapy (OT) authorizations and claims: modifier GO for OT services, modifier GP for PT services (regardless of whether provided by therapist or assistant), and modifier U7 when an assistant provides services without the supervising therapist on site. Authorization requests and corresponding claims must match exactly, including modifiers, or claims will be denied. For members with third-party liability or Medicare, modifiers KX, CO, and CQ must also be used when appropriate.
Low impact
[Virginia] Medication adherence: a silent epidemic
Anthem BCBS·Identified May 4, 2026
This is an informational provider bulletin from Anthem Blue Cross Blue Shield (Virginia) regarding medication adherence best practices for Medicare Advantage patients. It outlines evidence-based strategies to improve medication adherence (such as 90-day supplies, home delivery programs, and patient outreach) and calls on providers to implement these practices at the point of care. No billing code changes, prior authorization requirements, or coverage policy changes are specified.
Low impact
[Georgia] The Anthem Care Provider Recognition Program
Anthem BCBS·Identified May 4, 2026
Anthem is recognizing top 5% of care providers through their Care Provider Recognition Program (now in year 2) and expanding eligibility criteria to include Medicaid and Commercial providers starting in 2025. This is an informational/recognition program with no billing, coding, or claims processing changes required.
Medium impact
Dental MCP Reimbursement at the All-Inclusive Rate for Tribal Health Programs
Medi-Cal·Effective Jan 1, 2026
Effective immediately and retroactively to January 1, 2026, Dental Managed Care Plans must reimburse IHS-MOA clinics and Tribal FQHCs at the All-Inclusive Rate (AIR) for covered dental services when Medi-Cal members are enrolled in a Dental MCP. Providers must bill the member's assigned Dental MCP directly for reimbursement at the AIR rate.
Low impact
Justice-Involved (JI) Reentry Initiative: Trainings Scheduled for May and June 2026
Medi-Cal·Identified May 3, 2026
Medi-Cal is offering five training webinars in May and June 2026 for the Justice-Involved (JI) Reentry Initiative, covering billing procedures, behavioral health services, and claims processing for providers serving justice-involved populations. Providers must register through the Medi-Cal Learning Portal to attend.
Medium impact
Presumptive Eligibility Provider Update: 2026 FPL Programming Complete
Medi-Cal·Effective Mar 24, 2026
Medi-Cal has updated their Presumptive Eligibility systems with 2026 Federal Poverty Levels as of March 24, 2026. Providers can now request manual review of income-based denials that occurred between January 1-March 24, 2026, as these used outdated 2025 poverty levels.
Medium impact
Coming Soon: Important Policy Reminders and Clarifications for Covered Medi-Cal CHW Services
Medi-Cal·Identified May 3, 2026
California DHCS is updating the Medi-Cal Provider Manual to clarify billing requirements for Community Health Worker (CHW) preventive services, including individual and group billing procedures using specific CPT and HCPCS codes, and telehealth usage guidelines.
Medium impact
Temporary Solution for PE Confirmation Documents Printing Blank BIC Information in Provider Portal
Medi-Cal·Effective Apr 27, 2026
The Medi-Cal Provider Portal has a technical issue where Presumptive Eligibility (PE) confirmation documents are printing with blank Benefits Identification Card (BIC) numbers. Providers must verify all PE confirmation documents have complete information and contact specific DHCS programs via email or phone to obtain missing BIC numbers when needed.
Medium impact
Notice of Change for Provider Portal: Erroneous Payment Correction (EPC) Letters
Medi-Cal·Effective Apr 28, 2026
Medi-Cal is requiring providers to register for a Notice of Change regarding Erroneous Payment Correction (EPC) Letters through the Provider Portal. Providers must complete registration through the Medi-Cal Learning Portal web page to ensure enrollment and receive important updates about payment corrections.
Medium impact
Justice-Involved (JI) Reentry Initiative: New Course for Attestation Enhancement
Medi-Cal·Identified May 3, 2026
Medi-Cal is offering a new self-paced online training course titled 'Justice-Involved (JI) Reentry Initiative: Attestation Enhancement Notice of Change' through the Medi-Cal Learning Portal. Providers must register for the course and complete it to enhance their attestation requirements for serving justice-involved patients reentering the community.
Low impact
Justice-Involved (JI) Reentry Initiative: Provider Support Reminder
Medi-Cal·Effective Apr 30, 2026
Medi-Cal has issued a reminder about provider support resources for the Justice-Involved (JI) Reentry Initiative. Providers can contact the Telephone Service Center at 1-800-541-5555 for assistance with JI program inquiries, portal navigation, billing questions, and claim issues.
Low impact
St. Vincent Behavioral Health Campus Expands Housing & Health Care for LA with $6M Health Net Investment
Centene·Identified May 3, 2026
Health Net is investing $6M to develop the St. Vincent Behavioral Health Campus in Los Angeles, which will provide crisis care, transitional services, and housing for mental health and substance abuse patients. This is a corporate announcement about facility development rather than a billing policy change.
Low impact
Centene Announces New Executive Leadership Structure
Centene·Identified May 3, 2026
Centene Corporation announced new executive leadership changes with Daniel Finke appointed as Group President for Markets and Commercial (overseeing Medicaid and Commercial segments) and Michael Carson as Group President for Medicare and Specialty (overseeing Medicare Advantage, Part D, Duals, and Specialty businesses). This is a corporate restructuring announcement with no immediate operational changes for billing teams.
Low impact
Sunshine Health Delivers Career Pathways for Floridians and Advances Healthcare Workforce
Centene·Identified May 3, 2026
This is a press release announcing Sunshine Health's workforce development program results, not a policy change affecting billing operations. It reports training nearly 1,900 healthcare workers in 2025 through partnerships with Florida colleges and organizations.
Low impact
CENTENE CORPORATION TO HOST 2026 FIRST QUARTER FINANCIAL RESULTS EARNINGS CALL
Centene·Identified May 3, 2026
This is an earnings call announcement from Centene Corporation regarding their 2026 first quarter financial results presentation scheduled for April 28, 2026. This is a corporate communication for investors and does not contain any policy changes affecting medical billing practices.
Low impact
Sacramento Seniors Get More Affordable Housing and Infrastructure with Health Net's $3 Million Investment in SACOG and Mutual Housing California
Centene·Identified May 3, 2026
Health Net announced a $3 million investment in Sacramento area affordable housing and infrastructure projects, including funding for senior housing and community development. This is a corporate social responsibility announcement, not a policy change affecting medical billing or claims processing.
Low impact
Home State Health and Centene Foundation Launch Medical Respite Program in St. Louis
Centene·Effective Apr 23, 2026
Home State Health and Centene Foundation announced a $225,000 grant to launch St. Louis' first medical respite program for homeless individuals, providing post-acute care services. This is a corporate announcement about a new community health program, not a policy change affecting billing procedures.
Low impact
Los Angeles Residents to Gain Faster Access to New Affordable Housing through Health Net's $10 Million Investment in "Guarantee Fund"
Centene·Identified May 3, 2026
Health Net announced a $10 million investment in affordable housing development in Los Angeles County through a guarantee fund partnership. This is a corporate social responsibility initiative and does not impact medical billing, coding, or clinical operations.
Low impact
Superior HealthPlan Employees Contributed More Than 3,000 Volunteer Hours Across Texas Communities in 2025
Centene·Identified May 3, 2026
This is a press release about Superior HealthPlan's community volunteer activities and charitable giving in 2025, not a billing policy change. It announces employee volunteer hours and donation matching programs but contains no billing, coding, or reimbursement information relevant to medical billing teams.
Low impact
Centene Foundation Reports $34.9 Million Invested in Community Health, Education and Social Services in 2025
Centene·Identified May 3, 2026
This is a corporate press release from the Centene Foundation announcing their 2025 philanthropic investments totaling $34.9 million across community health, education, and social services programs. This does not contain any policy changes affecting medical billing, coding, or reimbursement.

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Archive by year

2023 2024 2025 2026

Reminder: Public Comment Period for Proposed EVV Rule Updates – Due by May 4

Provider Responsibility - Maintaining Records

FQHC and RHC Home Telemonitoring Providers Must Use Procedure Code S9110 With Modifier U3

New faxable Residential Prior Authorization Request Form

Changes to Substance Use Disorder (SUD) treatment services

Use modifiers with physical therapy (PT) and occupational therapy (OT) authorizations

[Virginia] Medication adherence: a silent epidemic

[Georgia] The Anthem Care Provider Recognition Program

Dental MCP Reimbursement at the All-Inclusive Rate for Tribal Health Programs

Justice-Involved (JI) Reentry Initiative: Trainings Scheduled for May and June 2026

Presumptive Eligibility Provider Update: 2026 FPL Programming Complete

Coming Soon: Important Policy Reminders and Clarifications for Covered Medi-Cal CHW Services

Temporary Solution for PE Confirmation Documents Printing Blank BIC Information in Provider Portal

Notice of Change for Provider Portal: Erroneous Payment Correction (EPC) Letters

Justice-Involved (JI) Reentry Initiative: New Course for Attestation Enhancement

Justice-Involved (JI) Reentry Initiative: Provider Support Reminder

St. Vincent Behavioral Health Campus Expands Housing & Health Care for LA with $6M Health Net Investment

Centene Announces New Executive Leadership Structure

Sunshine Health Delivers Career Pathways for Floridians and Advances Healthcare Workforce

CENTENE CORPORATION TO HOST 2026 FIRST QUARTER FINANCIAL RESULTS EARNINGS CALL

Sacramento Seniors Get More Affordable Housing and Infrastructure with Health Net's $3 Million Investment in SACOG and Mutual Housing California

Home State Health and Centene Foundation Launch Medical Respite Program in St. Louis

Los Angeles Residents to Gain Faster Access to New Affordable Housing through Health Net's $10 Million Investment in "Guarantee Fund"

Superior HealthPlan Employees Contributed More Than 3,000 Volunteer Hours Across Texas Communities in 2025

Centene Foundation Reports $34.9 Million Invested in Community Health, Education and Social Services in 2025