CurrentColorado Rocky Mountain Health PlansPolicy ADMINISTRATIVE 300.1

Adoption of UnitedHealthcare Commercial Medical Policies

This administrative policy states that effective January 1, 2026, Oxford will adopt UnitedHealthcare's Commercial Medical Policies for Oxford Commercial plan members and will stop maintaining separate Oxford-specific medical (clinical) policy versions; Oxford administrative policies remain accessible as before.

Policy Summary

PayerColorado Rocky Mountain Health Plans

PolicyAdoption of UnitedHealthcare Commercial Medical Policies

Policy CodePolicy ADMINISTRATIVE 300.1

Change TypeNew administrative policy (operational)

Effective DateJanuary 1, 2026

Next Review Date

Key ActionProviders should follow UnitedHealthcare Commercial Medical Policies for medical and drug policy determinations for Oxford Commercial members.

SourceLink

POLICY UPDATE CHANGES

New Administrative Policy created effective January 1, 2026 to adopt UnitedHealthcare Commercial Medical Policies.

Jan 1, 2026effective date

Oxford Commerciallines of business

UHCprovider.comadopted policy location

Nonerelated admin policies

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Adoption and Applicability

Applicability

Applies to Oxford Commercial plan membership; clinical coverage determinations for these members will follow UnitedHealthcare Commercial Medical & Drug Policies accessed at UHCprovider.com/policies.

Effective January 1, 2026, Oxford will utilize the UnitedHealthcare Commercial Medical Policies and will no longer maintain duplicate Oxford-specific Medical (Clinical) Policy versions.

Oxford Administrative Policies will remain accessible externally as before (no change to administrative policy external access).

What Providers Must Do

Prior Authorization

Follow UnitedHealthcare Commercial Medical & Drug Policies for Oxford Commercial Members

For Oxford Commercial members, follow the UnitedHealthcare Commercial Medical & Drug Policies accessed at UHCprovider.com/policies for medical and drug policy determinations; Oxford will no longer maintain separate Oxford-specific Medical (Clinical) Policy versions after January 1, 2026.

Terminology

Oxford — defined term

Defined termThe term Oxford includes Oxford Health Plans, LLC and all of its subsidiaries as appropriate for these policies.

ScopeApplies to Oxford policies referenced in this document; clarifies organizational entities covered by the term 'Oxford'.

Implication for policy languageWhen 'Oxford' is used elsewhere in policies, it refers to Oxford Health Plans, LLC and its subsidiaries for interpretation and enforcement.

Relation to member documentsPolicy terms remain subject to the member's contract or certificate; if a conflict exists, the member-specific benefit document governs.