{"id":8995,"date":"2026-09-30T20:51:23","date_gmt":"2026-09-30T20:51:23","guid":{"rendered":"https:\/\/hnetalk.com\/provider\/?p=8995"},"modified":"2026-10-01T19:07:12","modified_gmt":"2026-10-01T19:07:12","slug":"medical-policy-updates-october-2026","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/provider\/medical-policy-updates-october-2026\/","title":{"rendered":"Medical Policy Updates (October 2026)"},"content":{"rendered":"

Please read the following update related to various Health New England programs and changes that may have an impact on your patients and\/or your practice. To find policies noted below, please visit healthnewengland.org\/Providers\/Resources<\/strong><\/a>.<\/p>\n

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.<\/p>\n

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 <\/p>\n\n\n\n\n\n\n
Medical Policy Updates<\/strong><\/td>\nEffective Date<\/strong><\/td>\nNotes<\/strong><\/td>\n<\/tr>\n
In-Plan Homecare Requests<\/strong><\/p>\n

\u00a0<\/strong><\/td>\n

September 2026<\/td>\n\n
    \n
  • Commercial and Medicare Only<\/li>\n
  • As of September 1, 2026, prior authorization is no longer required for in-plan home care services.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
EviCore Program Expansion <\/strong><\/td>\nJanuary 2027<\/td>\nHealth New England has engaged with EviCore to conduct medical necessity review for the programs listed below. Medical Policies for these programs will be available on the EviCore website at https:\/\/www.evicore.com\/provider\/clinical-guidelines<\/a> by 11\/2\/2026:<\/p>\n

Radiation Oncology
\n<\/strong>Commercial and Medicare Advantage<\/em><\/p>\n

Medical Policy Updates<\/strong><\/p>\n

\u00a0<\/strong><\/td>\n

December 2026<\/td>\n\n