September 2021 Health Policy Update

ASHA monitors health policy updates in both public and private health plans across the United States. Below are the latest updates that could impact you or those you serve.

• Ambetter/Arkansas Health and Wellness [PDF]: A new policy was published for bone anchored hearing aids.
• Ambetter/Arkansas Health and Wellness [PDF]: A new policy was published for cochlear implants.
• Arizona Medicaid [DOCX]: An updated order form and new documentation is required for augmentative communication services.
• Blue Cross Blue Shield Minnesota Provider Bulletin [PDF]: Effective November 1, 2021, Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) will be updating its government program’s medical policy and preauthorization/precertification/notification lists.
• Blue Cross Blue Shield of Mississippi: An updated cochlear implant policy was posted that includes updates on certain devices.
• Centene Corporation and Associated Plans [PDF]: As part of an annual update on medical policies associated with bone anchored hearing aids, new healthcare common procedure coding system (HCPCs) codes have been added to the policy.
• Community Health Plans of Washington (Medicaid and Medicare Advantage) [PDF]: An update that includes criteria for bone conduction hearing aids for early and periodic screening, diagnostic and treatment consumers.
• Dean Health Plans [PDF]: A notice was published with updates to the coverage of hearing aids, prior authorization, and hearing test requirements.
• Kentucky Regulation [PDF]: A new rule was finalized that defines telehealth terminology within the state.
• Medical Mutual [PDF]: A new cochlear implant policy was published with updates to the medical necessity requirements.
• Neighborhood Health Plan of Rhode Island [PDF]: An update to the prior authorization policy and state of emergency waivers was provided. Some waivers were lifted as of September 30, and some policies remain in effect until the end of the year.
• Prevea360: An updated medical policy was published outlining new requirements for prior authorization and instruments for testing.
• SelectHealth Policy Update Bulletin: This bulletin includes an update to the use of communication devices, which removes requirement #6 concerning post 6-month follow up visit, regarding the use of the device.
• United Healthcare Community Plan for Nebraska [PDF]: An October 1 update bulletin includes coverage determination guideline updates for speech-generating devices (SGDs) that go into effect on November 1, 2021.
• United Healthcare for Kentucky Medicaid [PDF]: Effective September 1, 2021, changes to the language for coverage of SGDs were made, indicating that they be covered as durable medical equipment when not explicitly excluded from coverage. The new policy also lists examples of SGDs.
• United Healthcare of Oklahoma, Oregon, Texas, and Washington [PDF]: Effective September 1, 2021, changes to the supporting information in all four states. The Federal and State Mandated Regulations were updated in Oregon and Texas.
• University of Utah Health Plans (Commercial and Medicaid) [PDF]: A new policy was published for SGDs where they may be considered medically necessary when certain criteria are met.
• WellFirst Health Plans [PDF]: A notice was published with updates to the coverage of hearing aids, prior authorization, and hearing test requirements.
• Well Sense Health Plan [PDF]: An updated cochlear implant policy was published that includes a new separate statement for pediatric members as well as updates to medical criteria.