Key Updates
Medicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploads
Medicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 27, 2025
Care provider FAQs for Indiana PathWays for Aging Dual Care Plan
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Provider Satisfaction Survey reminder
Recent Updates
CommercialSeptember 1, 2025
Change to Prior Authorization Requirements
Specialty pharmacy updates — September 2025Medicare AdvantageSeptember 1, 2025
Medication safety: Reducing risks with thoughtful prescribing and monitoringMedicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploadsMedicare AdvantageSeptember 1, 2025
Elevate your practice efficiency with electronic prescriber toolsMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 27, 2025
Care provider FAQs for Indiana PathWays for Aging Dual Care PlanCommercialAugust 26, 2025
Change to Prior Authorization Requirements
New guidelines for PET radiotracer management in UM beginning December 1, 2025CommercialAugust 26, 2025
Change to Prior Authorization Requirements
Carelon Medical Benefits Management, Inc. Additional Outpatient Utilization Management and SurgicalMedicare AdvantageAugust 25, 2025
Anthem expands specialty pharmacy precertification listsEffective December 1, 2025
Avtozma, Osenvelt, Osenvelt, Stoboclo, and Xbryk
Medicare AdvantageAugust 21, 2025
Medication safety: Clinical strategies for EMR monitoring and preventionMedicare AdvantageAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
CommercialAugust 14, 2025
Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
Medicare AdvantageAugust 14, 2025
Precertification/prior authorization requirement changesEffective December 1, 2025
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 13, 2025
Claim updates and announcements for Indiana PathWays for Aging care providersHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 6, 2025
MCG Care Guidelines 29th Edition UpdatesCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 6, 2025
Update: National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listEffective November 1, 2025
Bomyntra, Conexxence, Imaav, Jobevne, Omlyclo, Qfitlia, Vyalev, and Jobevne
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 1, 2025
Upcoming changes to outpatient facility claims processingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 1, 2025
Transition of the Indiana SBIRT PIP to the PQIP framework for 2025CommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Change to Prior Authorization Requirements
Facility diagnostic radiopharmaceuticals and contrast mediaCommercialAugust 1, 2025
Support your patients with the CarelonRx, Inc. and Lark Weight Management ProgramCommercialAugust 1, 2025
SUD confidentiality protections for membersHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 1, 2025
Precertification prior authorization requirement changesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 29, 2025
You are invited: Indiana PathWays for Aging trainingMedicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025CommercialJuly 23, 2025
Carelon Medical Benefits Management, Inc. rehabilitation solution updateCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 18, 2025
LTSS Provider Quality Incentive Programs overviewCommercialJuly 16, 2025
Anthem update for rehabilitation therapyHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 14, 2025
Ensure smooth claim processing by including NPIs on skilled services facility claimsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 14, 2025
Indiana PathWays for Aging: Workforce Development resources and supportHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 8, 2025
The Provider Satisfaction Survey — Your opinion mattersHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Provider Satisfaction Survey reminderHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Best practices for managing provider referrals in the Care Central referrals dashboardHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 3, 2025
Streamlined referrals for Home and Community-Based Services careMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataCommercialMedicare AdvantageJuly 1, 2025
Provider manual update effective August 2025CommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
UM guidelines for timely service preapproval and reimbursementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
New incentive program — smoking cessation