| Ambetter Health Nevada Silver Summit Clinical | Behavioral Health Documentation Requirements | 2014-01-01 |
| Ambetter Health North Carolina Clinical | Behavioral Health Documentation Requirements | 2014-01-01 |
| Ambetter Health Louisiana Clinical | Behavioral Health Documentation Requirements | 2014-01-01 |
| Ambetter Health Kansas Sunflower Clinical | Behavioral Health Documentation Requirements | 2014-01-01 |
| Medicare NCD | NCD 40.5 - Treatment of Obesity | 2013-12-01 |
| Medicare NCD | NCD 100.11 - Gastric Balloon for Treatment of Obesity - RETIRED | 2013-12-01 |
| Medicare NCD | NCD 100.14 - Surgery for Diabetes - RETIRED | 2013-12-01 |
| Wellcare North Carolina Medicaid Clinical | Endometrial Ablation | 2013-03-01 |
| Sunshine Health Clinical Policy | Ambulatory Detoxification In Lieu of Service | 2013-02-01 |
| Wellcare Hawaii Medicaid Clinical | Quetiapine Extended-Release (Seroquel XR) | 2013-02-01 |