Effective July 1, 2017 Health Plan of Nevada and Sierra Health & Life will begin utilizing UnitedHealthcare (UHC) Medical Policies, Coverage Determination Guidelines and Drug Policies without converting them into the HPN/SHL format. In cases where the Nevada market varies from the UHC version, HPN/SHL will continue to utilize customized policies that will be indicated by the Health Plan of Nevada and Sierra Health and Life logos.
Although the UHC branded policies will indicate they are commercial policies, these will be used for all lines of business for Nevada. Please be certain to check the Medicare (CMS) and the Nevada Medicaid Services Manual (MSM) or other state Medicaid documents as applicable. When Medicaid is silent HPN/SHL will utilize the commercial coverage criteria for Medicaid members.
Protocols are listed by category. Due to the nature of medical technology these protocols are updated and, therefore, subject to change without notice.