CommercialCoverageMedium impact
Medical Policy Updates
EmblemHealth·Vascular Surgery, Oncology, Genetics +1 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare updated multiple medical policies including expanded Medicaid coverage for varicose vein treatments, new commercial/Medicare coverage for genetic tests, and clarified Medicare clinical trial device coverage. Several procedures were also reclassified as investigational.
Action Required
Immediately: Review current billing practices for varicose vein treatments, genetic testing (Abbott Alinity m STI Assay, Guardant Shield, IsoPSA, NavDx, Immunoscore), and radiofrequency ablation procedures. Billing team must verify coverage eligibility for these services based on updated guidelines and stop billing investigational procedures like Immunoscore and radiofrequency ablation for nonmetastatic desmoid tumors unless part of approved clinical trials.