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CommercialPrior AuthMedium impact

Fast Facts Newsletter - March 2026

HealthPartners·MN · Orthopedics·Prior Authorization
Effective date
Mar 1, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

HealthPartners has enhanced their prior authorization requirements tool with more accurate results sorted by line of business, clearer explanations when no authorization is required, and added genetic testing authorization requirements. Multiple medical policies have been revised including changes to artificial intervertebral disc replacement coverage and new prior authorization requirements for certain Medicaid orthotics effective May 1, 2026.

Action Required

Action needed
Immediately: Begin using the enhanced prior authorization requirements tool which now provides more accurate, personalized authorization requirements by member's insurance category and includes genetic testing requirements. By May 1, 2026: Billing team must update systems to require prior authorization for custom fabricated swing phase release and microprocessor-controlled knee-ankle-foot orthotics, and custom fabricated powered upper extremity assist devices for Medicaid plans. Review updated artificial intervertebral disc replacement coverage criteria as previous exclusions for cervical and lumbar fusion history have been removed.