MedicaidPrior AuthHigh impact
2026.38 - Provider Bulletin - Policy Updates and Changes to Clinical Review Criteria
Connecticut Medicaid (HUSKY Health)·CT · Urology, Ophthalmology, Cardiology +4 more·Provider Bulletin
Effective date
Aug 1, 2026
We identified it
Jul 23, 2026
Summary
Connecticut CMAP (HUSKY Health) is implementing significant clinical review criteria changes effective August 1, 2026. Five new policies are being introduced (BPH treatment, prostate cancer focal treatment, baroreflex device, corneal crosslinking, and corneal surgical procedures), 23 existing policies are being updated, and 4 policies are being retired. Billing teams must obtain updated clinical criteria from the HUSKY Health portal and implement new prior authorization requirements.
Action Required
By July 15, 2026: Billing team must access the HUSKY Health portal (https://portal.ct.gov/husky > Information for Providers > Policies, Procedures and Guidelines) to download all updated clinical review criteria effective August 1, 2026. For each of the 5 new policies and 23 updated policies, identify which procedures/devices your practice provides and update billing software with new prior authorization requirements. Stop billing under the 4 retiring policies (iTind, TULSA/TULSA Pro, Roctavian, Corneal Remodeling) after July 31, 2026 and transition to replacement policies. Provider staff and clinicians must review updated criteria to ensure documentation meets new medical necessity standards. Contact Community Health Network of CT at 1-800-440-5071 (8am-6pm) or Provider Assistance Center at 1-800-842-8440 (8am-5pm Mon-Fri) with questions about specific criteria. Failure to implement new prior authorization workflows will result in claim denials beginning August 1, 2026.