Effective March 31, 2025: Clinical Policies
Date: 03/26/25
Superior HealthPlan has updated certain clinical policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result the following policies are effective on March 31, 2025, at 12:00AM.
Changes in these policies reflect preauthorization requirement amendments that are less burdensome to insureds, physicians, or health care providers.
POLICY | APPLICABLE PRODUCTS | NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS |
Bariatric Surgery (CP.MP.37) | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) | Policy updates include:
|
Gastric Electrical Stimulation (CP.MP.40) | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, and Ambetter | Policy updates include:
|
NICU Apnea Bradycardia Guidelines (CP.MP.82) | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, and Ambetter | Policy updates include:
|
NICU Discharge Guidelines (CP.MP.81) | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, and Ambetter | Policy updates include:
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To review all policies, please visit Superior’s Clinical, Payment & Pharmacy Policies webpage.
Prior to updates, Medical Clinical policies are reviewed and approved by the Utilization Management Committee.
For questions or additional information, contact Superior HealthPlan Prior Authorization department at 1-800-218-7508.