Fast Facts Newsletter - August (Special Edition) 2026
Summary
HealthPartners moved management of its chiropractic provider network to Optum Health as of July 1, 2026, so chiropractic claims go directly to HealthPartners rather than Fulcrum, which ceases operations August 31, 2026. Several changes carry 2026 dates: Minnesota SUD services must be billed under the DHS Behavioral Health Fund Billing Grid effective October 1, 2026, power wheelchair prior authorization was expanded to include K0830 and K0831 effective 10/1/2026, and Cohere Health coverage criteria for Commercial, Medicaid and Medicare Advantage plans were revised effective 10/01/2026. Other updates include Actemra being replaced by the biosimilar Avtozma on the formulary, a Part B preference for Avtozma that applies only to new starts, and a revised temporomandibular disorder policy that removed diagnostic imaging from the list of non-surgical services.
Get alerts when payers change rules like this one
We check HealthPartners and other payers every day and email you when a change matches your specialty and state.