Medicare AdvantageAdministrativeMedium impact
Medicare: Change in post-acute care management in 3 states
UnitedHealthcare·MI, TX, IN·Medicare plan updates
Effective date
Jan 1, 2026
We identified it
Jan 12, 2026
Summary
Beginning Jan 1, 2026, UnitedHealthcare will take over Medicare utilization management for specific dual eligible Medicare Advantage plans in Michigan, Texas, and Indiana. Prior authorization requests for post-acute care services (skilled nursing, inpatient rehab, long-term acute care) must now be submitted through the UnitedHealthcare Provider Portal instead of Care Transitions.
Action Required
Before Jan 1, 2026: Billing and utilization management teams must transition from Care Transitions portal to UnitedHealthcare Provider Portal for prior authorization requests. Register for One Healthcare ID if not already done. Update workflows to submit all post-acute care prior authorizations (skilled nursing facilities, acute inpatient rehab, long-term acute care) through UnitedHealthcare Provider Portal for affected dual eligible plans only: Michigan Dual Complete H2247-005-000, Texas Dual Complete H3868-001-000, and Indiana PathWays H2385-003-000 and H2385-004-000.