Key Updates
MedicaidNovember 15, 2024
Targeted rate increase: update
CommercialMedicare AdvantageMedicaidNovember 1, 2024
Roster Automation updates: roster download functionality
MedicaidNovember 1, 2024
Join the Medicaid Medical Advisory Committee to make an impact on healthcare quality
CommercialMedicare AdvantageMedicaidOctober 24, 2024
Time to prepare for HEDIS medical record review
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Recent Updates
Medicare AdvantageNovember 19, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Medicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicaidNovember 15, 2024
Targeted rate increase: updateMedicare AdvantageNovember 15, 2024
California 2025 Medicare Advantage plan changesMedicaidNovember 13, 2024
Updated provider manual now availableCommercialNovember 6, 2024
Cost transparencyCommercialMedicare AdvantageMedicaidNovember 1, 2024
Roster Automation updates: roster download functionalityMedicaidNovember 1, 2024
Bayer announces withdrawal of Aliqopa® (copanlisib)MedicaidNovember 1, 2024
Community Supports services: cost-effective alternatives for eligible membersCommercialNovember 1, 2024
Personalized Match updateCommercialNovember 1, 2024
Welcome to the Pathway HMO NetworkMedicaidNovember 1, 2024
Join the Medicaid Medical Advisory Committee to make an impact on healthcare qualityMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsCommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableMedicare AdvantageMedicaidOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialMedicare AdvantageMedicaidOctober 24, 2024
Time to prepare for HEDIS medical record reviewMedicaidOctober 24, 2024
Provider: CAHPS awarenessCommercialOctober 23, 2024
Do you offer telehealth services? Let us know!CommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025Medicare AdvantageOctober 18, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective November 23, 2024
MedicaidOctober 17, 2024
Reminder: take action to protect infants from respiratory syncytial virus this seasonMedicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicare AdvantageOctober 15, 2024
Model of Care training reminderMedicaidOctober 14, 2024
You are invited: Lead poisoning prevention in childrenCommercialOctober 9, 2024
Provider transparency updateCommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025CommercialOctober 2, 2024
Reimbursement policy updates for facilitiesMedicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025Medicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from AnthemMedicare AdvantageOctober 1, 2024
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialOctober 1, 2024
Get ready to make a difference in healthcare: Participate in our 2024 Provider Satisfaction SurveyCommercialOctober 1, 2024
Pharmacy information available on our provider websiteCommercialMedicare AdvantageMedicaidOctober 1, 2024
HEDIS medical record submission made easier with our Remote EMR Access serviceCommercialOctober 1, 2024
National Accounts 2025 precertification listMedicaidOctober 1, 2024
Enhancing health: tobacco cessation requirements for Medi-Cal Managed Care providersCommercialOctober 1, 2024
Change in claims administration for Butte County schools