Medicare AdvantageAdministrativeHigh impact
October 2025: Provider changes and updates for 2026
Devoted Health·Provider News
Effective date
Jan 1, 2026
We identified it
Aug 13, 2026
Summary
Devoted Health has expanded to 9 new states (29 states total, 999 counties) effective January 1, 2026. Multiple benefit and administrative changes take effect, including: behavioral health administration transferred from Magellan to Devoted Health; vision/dental/DME/OTC/Food & Home benefits restructured by state; and significant Provider Manual updates affecting prior authorization, credentialing, medical records access, and C-SNP chronic condition verification requirements.
Action Required
By December 31, 2025: (1) Billing team must update eligibility verification systems to route behavioral health claims directly to Devoted Health, not Magellan Healthcare. Remove Magellan from behavioral health workflows. (2) Update prior authorization protocols: implement 24-hour notification requirement for D-SNP members in Pennsylvania and 7-day determination/notification timeframe for all prior auth services. (3) Medical records team must update procedures to provide access within 7 calendar days of request. (4) Credentialing team must implement updated Devoted Health credentialing procedures per 2026 Provider Manual. (5) Providers must implement C-SNP chronic condition verification process with 60-day deadline for existing members. (6) Front desk staff must update member ID card recognition to reflect new 2026 card images. (7) Billing team must verify which state(s) your practice serves to confirm applicable dental, vision, DME, and OTC vendors per the state-specific Delegated Partner Guide. (8) Review 2026 Formulary for medication coverage changes that may affect patient billing or prior authorization. (9) All staff must be trained on new Food & Home Card eligibility and supplemental benefit rules. Failure to implement behavioral health routing changes will result in claim denials and workflow delays.