Key Updates
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 19, 2025
Technical difficulties: My Diverse Patients
Medicare AdvantageFebruary 28, 2025
Important change to your patients’ specialty prescriptions
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 28, 2025
Frenectomy prior authorization update
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 28, 2025
Availity launches enhanced provider enrollment features for improved efficiency
Recent Updates
Medicare AdvantageMarch 19, 2025
Medicare Part B preapproval expands with new drug additionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 19, 2025
Technical difficulties: My Diverse PatientsMedicare AdvantageMarch 14, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025Medicare AdvantageMarch 14, 2025
Controlling High Blood Pressure (CBP) 2025Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 14, 2025
Prior authorization requirement changesEffective May 1, 2025
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 12, 2025
Resources to support diverse patients and communitiesMedicare AdvantageMarch 11, 2025
Care for Older Adults (COA) 2025Medicare AdvantageMarch 11, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective April 12, 2025
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 1, 2025
Reminder: provider data attestationCommercialMarch 1, 2025
Certain modifiers for outpatient claims will receive prepayment coding reviewCommercialMarch 1, 2025
Update: Drug claims edits to focus on FDA‑approved indicationsCommercialMarch 1, 2025
New coding guidelines: include the anatomic modifierCommercialMarch 1, 2025
Changes in Postal Service Health Benefits for 2025CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 1, 2025
New Communication Center added to Availity EssentialsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 1, 2025
Person-centered thinking hybrid trainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMarch 1, 2025
New federal rule transforms confidentiality protocols for SUD patient recordsMedicare AdvantageFebruary 28, 2025
Important change to your patients’ specialty prescriptionsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 28, 2025
Frenectomy prior authorization updateCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 28, 2025
Availity launches enhanced provider enrollment features for improved efficiencyMedicare AdvantageFebruary 21, 2025
Advanced Illness and Frailty Exclusions 2025Medicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 21, 2025
Reminder of claims submissions for FQHCs/RHCs for T1015CommercialFebruary 21, 2025
Start 2025 with an easy way to earn continuing education creditsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 20, 2025
Important update for HCBS providers: guidelines for using alternative EVV vendorsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 20, 2025
MCG Care Guidelines 29th editionEffective May 1, 2025
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingFebruary 18, 2025
Guideline update for Carelon Medical Benefits Management, Inc.CommercialFebruary 18, 2025
Change to Prior Authorization Requirements
MCG Care Guidelines 29th editionEffective June 1, 2025
CommercialFebruary 11, 2025
Developmental screening in the first three years of lifeCommercialFebruary 11, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025CommercialFebruary 11, 2025
Chlamydia Screening (CHL) 2025CommercialFebruary 10, 2025
Colorectal Cancer Screening (COL-E) 2025CommercialFebruary 4, 2025
Expansion of Carelon Medical Benefits Management, Inc. programsCommercialFebruary 1, 2025
Change to Prior Authorization Requirements
Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and FacilityMedicare AdvantageFebruary 1, 2025
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialFebruary 1, 2025
Avoidance of Antibiotics Treatment for Acute Bronchitis/Bronchiolitis (AAB)CommercialFebruary 1, 2025
Designated specialty pharmacy network updatesCommercialFebruary 1, 2025
Change to Prior Authorization Requirements
Medical records needed for accurate payment of certain facility inpatient claimsCommercialMedicare AdvantageFebruary 1, 2025
2025 Clinical Quality in Practice webinar seriesCommercialFebruary 1, 2025
Pharmacy information available on our provider websiteCommercialFebruary 1, 2025
New reimbursement policy: Place of Service — ProfessionalCommercialFebruary 1, 2025
Corrected claim guidance for the Federal Employee Program®Medicare AdvantageJanuary 28, 2025
Eye Exam for Patients with Diabetes (EED) 2025CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJanuary 28, 2025
Enhance patient coordination with Total Member ViewCommercialJanuary 27, 2025
Key formulary updates: effective January 1, 2025CommercialJanuary 22, 2025
Breast Cancer Screening (BCS-E) 2025CommercialJanuary 22, 2025
Statin Therapy for Patients with Cardiovascular Disease (SPC) 2025CommercialJanuary 21, 2025
Eye Exam for Patients with Diabetes (EED) 2025