CommercialAdministrativeHigh impact
Georgia: Review key referral and billing protocols
UnitedHealthcare·GA·State news
Effective date
Feb 1, 2026
We identified it
Mar 1, 2026
Summary
UnitedHealthcare Georgia has implemented new requirements for out-of-network referrals, balance billing protocols, and weight-loss medication prescriptions. Most significantly, only 9amHealth providers can now prescribe weight-loss medications for Georgia State Health Benefit Plan members in HMO/HDHP plans, effective February 1, 2026.
Action Required
Immediately: 1) Billing team must update protocols to ensure all out-of-network referrals go through proper authorization process except emergencies. 2) Front desk staff must use Member Advance Notice forms before providing any non-covered services to prevent balance billing issues. 3) Providers must stop prescribing weight-loss medications for Georgia SHBP HMO/HDHP members and direct them to enroll at join9am.com/shbp or call 888-870-9542. Note: This does not apply to diabetic GLP-1s like Ozempic and Mounjaro. 4) Update EMR alerts to flag Georgia SHBP members needing weight-loss medications.