Key Updates
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Provider Satisfaction Survey reminder
Recent Updates
Medicare AdvantageAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesCommercialAugust 14, 2025
Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesMedicare 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 listCommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideHoosier 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 2025CommercialMedicare 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 healthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingAugust 1, 2025
Upcoming changes to outpatient facility claims processingCommercialAugust 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 1, 2025
New incentive program — smoking cessationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
UM guidelines for timely service preapproval and reimbursementMedicare 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
Simplify care with our Complex Care Management programHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Earn CME credits: Attend our engaging webinarsCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialMedicare AdvantageJuly 1, 2025
Provider manual update effective August 2025CommercialJuly 1, 2025
Enroll with Availity to verify your provider dataMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
Change to Prior Authorization Requirements
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityCommercialJuly 1, 2025
Change to Prior Authorization Requirements
Reimbursement policy update: Bundled Services and Supplies — ProfessionalCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 27, 2025
National Drug Codes (NDC) Are Required for Outpatient ClaimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
CommercialJune 25, 2025
Provider specialty and subspecialty designations for utilization management