Medicare AdvantagePrior AuthHigh impact
Read Full Update October monthly overview
UnitedHealthcare·AZ, LA, PA, MN, MO, NJ, NY, CA, OH·Protocol
Effective date
Jan 1, 2025
We identified it
Mar 11, 2026
Summary
UnitedHealthcare released their October 2024 monthly policy overview with multiple updates including new prior authorization requirements for Medicare Part B step therapy medications starting January 1, 2025, electronic submission requirements for Medicaid reconsiderations in several states, and various administrative portal changes.
Action Required
By January 1, 2025: Billing team must update workflows to obtain prior authorization for all Medicare Part B Step Therapy Program medications before prescribing. By November 8, 2024: Arizona, Louisiana, and Pennsylvania Medicaid providers must transition to electronic-only submissions for claim reconsiderations and appeals - update billing staff training and remove paper submission processes. By March 1, 2025: All staff must update UnitedHealthcare Provider Portal sign-in methods per new security requirements.