Medical News and Information

Important News

We have collected and categorized the most recent policy updates, product updates, and company information that may be useful to you.

Status Codes Reimbursement Policy Update – Codes 99050 and 99051
2022-01-21 -
Physicians/Specialists
Facilities/Hospitals
Update: Discontinued IU65 ACA Members with Pharmacy Medical Authorizations Spanning into 2022
2022-01-21 -
Physicians/Specialists
Facilities/Hospitals
Pharmacy
Medical Step Therapy Updates for Healthy Blue + MedicareSM (HMO D-SNP)
2022-01-20 -
Physicians/Specialists
Facilities/Hospitals
Pharmacy
Update: Plan Transition for City of New York Retirees
2022-01-20 -
Physicians/Specialists
Facilities/Hospitals
Update: HEDIS Kickoff Call
2022-01-20 -
Physicians/Specialists
Facilities/Hospitals
New Update: Medicare Advantage Quality Incentive Program (MAQIP) Policy Effective January 1, 2022
2022-01-20 -
Physicians/Specialists
Facilities/Hospitals
Coverage of Over-the-Counter (OTC) COVID-19 Tests for Members
2022-01-14 -
Physicians/Specialists
Facilities/Hospitals
State Health Plan Member ID Change for 2022
2022-01-14 -
Physicians/Specialists
Facilities/Hospitals
Itemized Bill Review (IBR) Program Effective Date for Commercial Business
2022-01-13 -
Physicians/Specialists
Facilities/Hospitals
Reinstating Temporary Prior Authorization Waivers for Skilled Nursing Facilities, Home Health Services and Residential Treatment Centers - Effective January 10, 2022
2022-01-07 -
Physicians/Specialists
Facilities/Hospitals
Post-Service Provider Appeals Dates Extended
2022-01-07 -
Physicians/Specialists
Facilities/Hospitals
New Update: Participating Laboratory List and a Reminder About Use of the Avalon Network
2022-01-05 -
Physicians/Specialists
Facilities/Hospitals
Prior Authorization Changes for Inpatient Admissions Following Emergency Department Visit - Effective January 1, 2022
2021-12-30 -
Physicians/Specialists
Facilities/Hospitals
IMPORTANT NEWS: Medicare Advantage Notifications Effective January 1, 2022
2021-12-27 -
Physicians/Specialists
Facilities/Hospitals
Delays for Enrolling New Providers
2021-12-22 -
Physicians/Specialists
Facilities/Hospitals
New Update: Reinstating Medicare 2 Percent Payment Reduction
2021-12-22 -
Physicians/Specialists
Facilities/Hospitals
Ancillary
Pharmacy
Submitting Claims and Eligibility Inquiries for State Health Plan Members that Span 2021 and 2022
2021-12-22 -
Physicians/Specialists
Facilities/Hospitals
Speech Therapy Claims Issue
2021-12-22 -
Physicians/Specialists
Facilities/Hospitals
Availity Authorization app available to providers beginning in 2022
2021-12-22 -
Physicians/Specialists
Facilities/Hospitals
Medical Record Review for HEDIS Measurement Year 2021 Begins in February
2021-12-13 -
Physicians/Specialists
Facilities/Hospitals
New Diagnosis Related Group (DRG) and Itemized Bill Review (IBR) Programs Starting May 2021
2021-12-10 -
Physicians/Specialists
Facilities/Hospitals
Xolair Transition to Self-Administered Formulation
2021-12-09 -
Physicians/Specialists
Facilities/Hospitals
Pharmacy
Opioid Treatment Program (OTP) Update
2021-12-08 -
Physicians/Specialists
Facilities/Hospitals
State Supplied Vaccines
2021-12-08 -
Physicians/Specialists
Facilities/Hospitals
COVID-19-Related Treatment Cost Waiver Extension to Expire on June 30, 2021
2021-12-07 -
Physicians/Specialists
Facilities/Hospitals
Pharmacy
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