CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingDecember 1, 2024

December 2024 Provider Newsletter

Featured Articles

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 8, 2024

Reminder: Take action to protect infants from respiratory syncytial virus this season

Quality ManagementCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024

Time to prepare for HEDIS medical record review

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024

Roster Automation updates: roster download functionality


Administrative

AdministrativeMedicare AdvantageNovember 18, 2024

Indiana 2025 Medicare Advantage plan changes

AdministrativeCommercialDecember 1, 2024

Case Management program

AdministrativeCommercialDecember 1, 2024

PCP after‑hours access requirements

AdministrativeCommercialDecember 1, 2024

Coordination of care

AdministrativeMedicare AdvantageDecember 1, 2024

Iron Workers Local 395 Trust Fund moves to Anthem

AdministrativeCommercialDecember 1, 2024

Clinical practice and preventive health guidelines available online

AdministrativeCommercialDecember 1, 2024

Important information about utilization management

AdministrativeMedicare AdvantageNovember 15, 2024

Skilled nursing facility — vaccine serum compensation

AdministrativeCommercialDecember 1, 2024

Members’ Rights and Responsibilities

Digital SolutionsMedicare AdvantageNovember 18, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingMedicare AdvantageNovember 18, 2024

Notice of change: Part D Rx HCCs

Policy Updates

Policy UpdatesMedicare AdvantageOctober 30, 2024

Clinical Criteria updates

Effective December 2, 2024

Medical Policy & Clinical GuidelinesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 15, 2024

Medical Policies, Clinical Utilization Management Guidelines update

Effective December 31, 2024

Reimbursement PoliciesCommercialDecember 1, 2024

Change to Prior Authorization Requirements

New reimbursement policy: Trauma Activation — Facility

Products & Programs

Products & ProgramsCommercialNovember 21, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Federal Employee Program (FEP)CommercialDecember 1, 2024

FEP excited to join PSHB program in 2025

PharmacyCommercialDecember 1, 2024

Pharmacy information available online

PharmacyCommercialDecember 1, 2024

Kroger Specialty Pharmacy acquisition

PharmacyCommercialNovember 18, 2024

Change to Prior Authorization Requirements

Specialty pharmacy updates — December 2024

Quality Management

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024

Provider: CAHPS awareness

INBCBS-CDCRCM-072810-24

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).