UHC Community Plan Adds 3 States to Prior Authorization

August 26, 2019
Rick Gawenda

UnitedHealthcare (UHC) Community Plan is adding 3 states (in addition to the 4 previously announced) that will require prior authorization prior to initiating physical, occupational and/or speech therapy services. In addition, UHC Community Plan is adding site of service medical necessity reviews for all speech, occupational and physical therapy services provided in a hospital outpatient setting in 2 of the 3 states.

The new impacted states are

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  1. Rick, not sure if you can answer this or if I need to try to contact UHC directly, but does this also include the UHC Dual Complete plans? (Medicare and Medicaid combined into one?) Or simply the Medicaid only version? (We’re in NY). Thanks!

    1. It states UHC Community Plan so I would say no, but it’s always the providers responsibility to check so I would recommend you contact UHC if you have questions.