Medicare AdvantagePrior AuthHigh impact
24-184 View the New Web Page for Medicare Medical Policies
Health Net·CA · Oncology, Cardiothoracic Surgery, Pulmonology +6 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Centene has updated their Medicare medical policies webpage with 11 revised clinical policies and new Concert Genetics testing policies, all effective January 1, 2024. The updated policies cover various procedures including radiation therapy, transplants, and genetic testing, with new prior authorization requirements and coverage criteria.
Action Required
Immediately: Billing team must access the new Medicare Prior Authorization Medical Clinical Policies webpage to review updated coverage criteria for the 11 revised policies (including radiation therapy, transplants, and genetic testing). Update prior authorization workflows and verify eligibility requirements for affected procedures. Contact Provider Services Center at 800-929-9224 with questions. Claims may be denied if new prior authorization requirements are not followed.