Clinical Policy Updates

Date: 07/14/26

Wellcare 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, clinical policies are reviewed and approved by the National Medicare Quality Improvement & Management Committee (QI/UMC).

All new policies and policies with updates may be found on our Medical Clinical Policy Updates page. The full list of policies may be found on the Clinical and Payment Policies page.

Please reach out to your Provider Engagement Administrator if you have any questions.

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

Policy Updates Effective: November 10^th, 2026

We always want to hear from you! If you notice anything missing or have suggestions for additional materials that would support your work, please let us know by submitting feedback through our Provider Feedback Form.

Need Help or Have Questions? Reach out to us through the following channels:

1. Provider Services – 1-833-919-3214, Monday – Friday 8am – 5pm EST 
2. General inquiries, email - DE_ProviderEngagement@DelawareFirstHealth.com
3. Contact your dedicated Provider Engagement Account Manager