Provider Connection
Medical Policy Updates – August Newsletter 2026
Provider Connection
Medical Policy Updates – August Newsletter 2026
University of Utah Health Plans uses medical policies as guidelines for coverage determinations in accordance with the member's benefits. Quarterly notice of recently approved and revised medical policies is provided in Provider Connection for your convenience. The Medical Policy Updates section of this newsletter does not indicate that coverage is provided for the procedures listed.
| REVISED POLICIES | |||
|---|---|---|---|
| Policy Number | Policy Name | Effective Date | Summary |
| MP-002 (Revised) | Gender Affirming Surgery | 03/27/2026 | Commercial: Removed ambiguous language regarding procedures for non-binary individuals. |
| MP-040 (Revised) | Low Dose Computed Tomography for Lung Cancer Screening | 03/28/2026 | Commercial: Revision clarifying that all criteria must be met for coverage and aligned with preventive screening standards. |
| MP-005 (Revised) | Balloon Dilation of the Eustachian Tube | 04/27/2026 | Commercial: References updated. |
| MP-066 (Revised) | Myocardial Strain Imaging | 04/28/2026 | Commercial: Clinical rationale streamlined and references updated. |
| MP-045 (Revised) | General Policy on Genetic Testing | 06/29/2026 | Commercial: Updated description, rationale and references. |
| MP-082 (Revised) | Cardiac Fludeoxyglucose-Positron Emission Tomography (FDG-PET) Scans | 06/29/2026 | Commercial: Clarified myocardial perfusion assessment criteria to include individuals with indeterminate SPECT scan. |
| ARCHIVED POLICIES | ||
|---|---|---|
| Policy Number | Policy Name | Effective Date |
| MP-075 (Archived, under pharmacy management) | Autologous Chondrocyte Implantation | 03/27/2026 |
| MP-038 (Archived, using InterQual criteria) | Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy) | 03/28/2026 |
| MP-036 (Archived) | Transcutaneous (Non-implantable) Vagus Nerve Stimulation (e.g. gammaCore) | 05/29/2026 |
| MP-012 (Archived, using InterQual criteria) | Formulas and Other Enteral Nutrition | 05/30/2026 |
| MP-026 (Archived, under pharmacy management) | Drug Levels and Antibody Testing for Infliximab, Adalimumab, Vedolizumab and Ustekinumab | 05/29/2026 |
| MP-042 (Archived, using InterQual criteria) | Electric Tumor Treatment Field Therapy | 05/29/2026 |
| MP-028 (Archived) | Vitamin D Testing | 05/29/2026 |