May 1, 2025

May 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for Aging

Featured Articles


Administrative

AdministrativeCommercialMay 1, 2025

Upcoming changes to the provider manual effective August 2025

Behavioral Health

Behavioral HealthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 1, 2025

FDA lifts risk evaluation and mitigation strategy reporting requirements for Clozapine

Education & Training

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 29, 2025

Contractual obligations for care coordination and case management engagement

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 7, 2025

FAQ for Care Central

Education & TrainingCommercialMay 1, 2025

Streamline your prior authorizations with our digital tools

Policy Updates

Medical Policy & Clinical GuidelinesCommercialApril 10, 2025

Change to Prior Authorization Requirements

Medical Policies and Clinical Guidelines updates, May 2025

Medical Policy & Clinical GuidelinesMedicare AdvantageApril 24, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective May 25, 2025

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageApril 30, 2025

Change to Prior Authorization Requirements

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Effective August 1, 2025

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 2, 2025

Precertification/prior authorization requirement changes

Effective June 1, 2025

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 29, 2025

Prior authorization requirement changes

Effective July 1, 2025
CPT Codes: E0468, E0482, and E0617

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingApril 21, 2025

New preapproval requirements for coronary artery catheter placement procedures

Products & Programs

PharmacyMedicare AdvantageApril 18, 2025

New specialty pharmacy medical step therapy requirement

Effective June 1, 2025
Hercessi

PharmacyMedicare AdvantageApril 18, 2025

Specialty pharmacy preapproval list update

Effective August 1, 2025
Jubbonti; Wyost


INBCBS-CDCRCM-081392-25-CPN81360