| BCBS Kansas | Total Artificial Hearts and Ventricular Assist Devices | 2023-10-02 |
| Sunshine Health Clinical Policy | supports the utilization management review process for the LTC benefits described in the Florida Agency for Health Care | 2023-10-01 |
| Sunshine Health Clinical Policy | Long Term Care Skilled Therapy Clinical Policy | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | Ferriscan R2-MRI | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | IV Moderate Sedation, IV Deep Sedation and General Anesthesia for Dental Procedures | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | Orthognathic Surgery | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | Panniculectomy | 2023-10-01 |
| Wellcare Kentucky Medicaid Clinical | Pediatric Heart Transplant | 2023-10-01 |
| Sunshine Health Clinical Policy | Skilled Nursing Clinical Policy | 2023-10-01 |