UnitedHealthcare policy updates
Track new and updated UnitedHealthcare policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Enhanced behavioral health value-based reimbursement criteria | UnitedHealthcare | Reimbursement | — | Modified | Jul 1, 2027 |
| Federal/State Mandated Regulations | UnitedHealthcare | Administrative | — | Modified | Aug 1, 2026 |
| Bariatric Surgery (for Nebraska Only) | UnitedHealthcare | Clinical | Bariatric & Obesity Management | Modified | Aug 1, 2026 |
| Bariatric Surgery (for Kentucky Only) | UnitedHealthcare | Clinical | Bariatric & Obesity Management | Modified | Aug 1, 2026 |
| RNA-Targeted Therapies (Amvuttra and Onpattro) — Medical Benefit Drug Policy (Ohio-only) | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Catheter Ablation for Atrial Fibrillation (for Idaho Only) | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Genetic Testing for Cardiac Disease (for Idaho Only) | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Myqorzo (aficamten) prior authorization for obstructive hypertrophic cardiomyopathy | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Transcatheter Procedures for Heart Valve Conditions (Kentucky) | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Transcatheter Procedures for Heart Valve Conditions (for Kansas Only) | UnitedHealthcare | Clinical | Cardiology | Modified | Aug 1, 2026 |
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OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.