Clinical Coverage Policy Updates - Effective September 14th

Date: 07/14/26

Policy Updates Effective: September 14, 2026

Delaware First Health reviews all clinical policies at least annually. This review is done to ensure medical necessity review criteria is current and appropriate for members and the scope of the services. On a quarterly basis, prior to updates, policies are reviewed and approved by Delaware First Health’s Quality Improvement and Utilization Management Committee (QI/UMC). This announcement reflects all revised and updated policies.

The full list of active policies can be found in the Clinical and Payment Policies, a subsection under Provider Resources.

Please reach out to your assigned Provider Engagement Account Manager if you have any questions.

POLICY NUMBER	POLICY TITLE	DATE OF REVISIONS/ EFFECTIVE DATE
Clinical Policies with Changes
CP.MP.37	Bariatric Surgery	02/2026
CP.BH.500	Behavioral Health Treatment Documentation Requirements	04/2026
CP.BH.201	Deep Transcranial Magnetic Stimulation for the Treatment of Obsessive Compulsive Disorder	02/2026
CP.MP.132	Heart-Lung Transplant	02/2026
CP.MP.184	Home Ventilators	02/2026
CP.MP.69	Intensity-Modulated Radiotherapy	02/2026
CP.MP.58	Intestinal and Multivisceral Transplant	04/2026
CP.MP.244	Liposuction and Lipedema	04/2026
CP.MP.57	Lung Transplantation	02/2026
CP.MP.246	Pediatric Kidney Transplant	02/2026
CP.MP.185	Skin and Soft Tissue Substitutes	04/2026
CP.MP.247	Transplant Service Documentation Requirements	04/2026
New Clinical Policies
CP.MP.107	DME Policy	08/2025
CP.MP.54	Hospice Services	05/2026
CP.MP.252	Immobilized Lipase Cartridges (Relizorb)	02/2026
CP.MP.194	Osteogenic Stimulation	05/2026
CP.MP.190	Oxygen Use and Concentrators	11/2025
Retired
CP.MP.14	Cochlear Implant Replacements	04/2026
DE.CP.MP.107	DME Policy	11/2025
CP.MP.126	Sacroiliac Joint Fusion	04/2026