11/19/2025

United Healthcare

Molina Managed Care Committee Member

Whitney Williams, CPB - Newland Medical Associates

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Medical Policy Update

• UnitedHealthcare Commercial 
• UnitedHealthcare Individual Exchange 
• UnitedHealthcare Community Plan 
• UnitedHealthcare Medicare Advantage 
• United Medical Resources Policy Update

Reimbursement Policy Updates

• UnitedHealthcare Commercial Plan 
• UnitedHealthcare Individual Exchange 
• UnitedHealthcare Community Plan 
• UnitedHealthcare Medicare Advantage 

Pharmacy and Clinical Updates

• Q4 2025 preferred drug list updates 
• Notice of Changes to Prior Authorization Requirements and Coverage Criteria for UnitedHealthcare Commercial 

Review these documents for more information about prior authorization requirements and medical necessity coverage criteria for Part B medications that have utilization management programs in place.

• Medicare Part B Step Therapy Programs
• Medicare Prior Authorization Requirements 

Specialty Drugs and Benefit Update

• Medical Benefit Specialty Medication Update Bulletin: November 2025

Other

• Prior Authorization Tool  

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