High impact
Fast Facts Newsletter - August (Special Edition) 2026
HealthPartners·Effective Jul 1, 2026
HealthPartners issued a comprehensive policy update affecting pharmacy formularies, medical coverage criteria, and administrative operations. Key changes include: (1) Chiropractic claims routing transition from Fulcrum Health to direct HealthPartners submission effective July 1, 2026; (2) SUD billing requirements alignment with Minnesota DHS Behavioral Health Fund Grid effective September 1, 2026; (3) Multiple drug formulary and pharmacy policy updates favoring biosimilars (Avtozma over Actemra, Mvasi/Vegzelma over Avastin); (4) Medical policy revisions for TMD diagnostics, wheelchair codes, and Cohere coverage criteria effective October 1, 2026.