Kentucky
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Keep up with Medicaid News - December 2022

- Prior authorization updates for medications billed under the medical benefit (Fyarro, BESREMi, Vyvgart, Adbry, Leqvio)
- New specialty pharmacy medical step therapy requirements (Mvasi, Avastin, Zirabev)
December 2022 Anthem Provider News - Kentucky Medicaid Dec 1, 2022

Monkeypox resources and recommendations for our care providers

December 2022 Anthem Provider News - Kentucky Medicaid Dec 1, 2022

Important information about utilization management

December 2022 Anthem Provider News - Kentucky Medicaid Dec 1, 2022

Keep up with Medicare News - December 2022

- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
December 2022 Anthem Provider News - Kentucky Medicare Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Anthem Provider News - Kentucky Medicare Dec 1, 2022

Personal home helper benefit ending

December 2022 Anthem Provider News - Kentucky Medicare Dec 1, 2022

Keep up with Medicaid News - November 2022

- Prior authorization requirement changes effective November 1, 2022
- Provider notice for COVID-19 testing
- New phone number for AIM Specialty Health
- Prior authorization requirement changes
- Mental health needs during the eastern Kentucky flood
- New specialty pharmacy medical step therapy requirements
November 2022 Anthem Provider News - Kentucky Medicaid Nov 1, 2022

Personalized Match

November 2022 Anthem Provider News - Kentucky Medicare Nov 1, 2022

Enhancing claims attachment processes through digital applications

November 2022 Anthem Provider News - Kentucky Medicaid Nov 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

November 2022 Anthem Provider News - Kentucky Medicaid Nov 1, 2022

Alcohol use disorders often coexist with psychiatric disorders

November 2022 Anthem Provider News - Kentucky Medicaid Nov 1, 2022

Guidance for coding evaluation and management services for new and established patients

November 2022 Anthem Provider News - Kentucky Medicaid Nov 1, 2022

Keep up with Medicare News - November 2022

- Medical drug benefit Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
- New specialty pharmacy medical step therapy requirements (Zarxio)
- Provider notice for COVID-19 testing
November 2022 Anthem Provider News - Kentucky Medicare Nov 1, 2022

Enhancing claims attachment processes through digital applications

November 2022 Anthem Provider News - Kentucky Medicare Nov 1, 2022

Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

November 2022 Anthem Provider News - Kentucky Medicare Nov 1, 2022

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

October 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Oct 1, 2022

Keep up with Medicare News - October 2022

  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
  • Anthem expands specialty pharmacy precertification list-1
  • Anthem expands specialty pharmacy precertification list-2
  • Consultation codes
October 2022 Anthem Provider News - Kentucky Medicare Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

October 2022 Anthem Provider News - Kentucky Medicare Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

October 2022 Anthem Provider News - Kentucky Medicare Oct 1, 2022

Keep up with Medicaid News - October 2022

  • Prior authorization update for select durable medical equipment (DME) items
  • Prior authorization updates for medications billed under the medical benefit-1
  • Prior authorization updates for medications billed under the medical benefit-2
  • HPV Vaccine Provider Incentive program for members aged 13
October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

Medical drug benefit Clinical Criteria updates

October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

New Digital Provider Enrollment tool added to Availity

October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

Clinical Criteria updates

October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

Members’ Rights and Responsibilities section

October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

Updates for medication codes billed under the medical benefit

October 2022 Anthem Provider News - Kentucky Medicaid Oct 1, 2022

New Digital Provider Enrollment tool added to Availity

October 2022 Anthem Provider News - Kentucky Medicare Oct 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Sep 1, 2022

Anthem Medicaid responds to those affected by floods in eastern Kentucky

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

Keep up with Medicaid News - September 2022

- New Strategic Provider System will launch in August 2022
- Clinical criteria updates
- COVID-19 Vaccine Provider Incentive Program ages 6 months+
- Prior authorization updates for medications billed under the medical benefit
September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

Specialty pharmacy site of care program retraction

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

Complex Case Management program

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

New reimbursement policy: Diagnosis-related group newborn inpatient stays - Facility

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

New specialty pharmacy medical step therapy requirements

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

Alcohol use disorders linked to chronic diseases

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

InterQual 2022 revisions

September 2022 Anthem Provider News - Kentucky Medicaid Sep 1, 2022

Keep up with Medicare News - September 2022

- Anthem expands specialty pharmacy precertification list
- Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
- New Strategic Provider System will launch in August 2022
September 2022 Anthem Provider News - Kentucky Medicare Sep 1, 2022

Reminder: AIM prior authorization phone number change for Medicare

September 2022 Anthem Provider News - Kentucky Medicare Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Provider News - Kentucky Medicare Sep 1, 2022

Anthem expands specialty pharmacy precertification list

September 2022 Anthem Provider News - Kentucky Medicare Sep 1, 2022

Reimbursement policy update: Modifiers 25 and 57 - Evaluation and Management with Global Procedures

September 2022 Anthem Provider News - Kentucky Medicare Sep 1, 2022

Keep up with Medicaid News - August 2022

- Medical drug benefit Clinical Criteria updates
August 2022 Anthem Provider News - Kentucky Medicaid Aug 1, 2022

Prior authorization requirement changes effective November 1, 2022

August 2022 Anthem Provider News - Kentucky Medicaid Aug 1, 2022

Chlamydia screening

August 2022 Anthem Provider News - Kentucky Medicaid Aug 1, 2022

Using SBIRT to address opioid and substance use disorders

August 2022 Anthem Provider News - Kentucky Medicaid Aug 1, 2022

The cost of alcohol use disorder

August 2022 Anthem Provider News - Kentucky Medicaid Aug 1, 2022

Keep up with Medicare News - July 2022

- New specialty pharmacy medical step therapy requirements
July 2022 Anthem Provider News - Kentucky Medicare Jul 1, 2022

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Anthem Provider News - Kentucky Medicare Jul 1, 2022

Cancer Care Navigator

July 2022 Anthem Provider News - Kentucky Medicare Jul 1, 2022

Keep up with Medicaid News - July 2022

- Prior authorization updates for medications billed under the medical benefit
July 2022 Anthem Provider News - Kentucky Medicaid Jul 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

July 2022 Anthem Provider News - Kentucky Medicaid Jul 1, 2022

Diabetes self-management education and support

July 2022 Anthem Provider News - Kentucky Medicaid Jul 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

July 2022 Anthem Provider News - Kentucky Medicare Jul 1, 2022

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

June 2022 Anthem Provider News - Kentucky Medicare Jun 1, 2022

Process change for Federal Employee Program third-party correspondence requests

June 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Jun 1, 2022

Reimbursement policy update: Inpatient Readmissions

June 2022 Anthem Provider News - Kentucky Medicaid Jun 1, 2022

Keep up with Medicare News - June 2022

June 2022 Anthem Provider News - Kentucky Medicare Jun 1, 2022

Evaluation and management services for COVID testing - professional

June 2022 Anthem Provider News - Kentucky Medicare Jun 1, 2022

Medical drug benefit clinical criteria updates

June 2022 Anthem Provider News - Kentucky Medicare Jun 1, 2022

Medical policies and clinical utilization management guidelines update

June 2022 Anthem Provider News - Kentucky Medicare Jun 1, 2022

Keep up with Medicaid News - May 2022

- Medical drug benefit Clinical Criteria updates-March 2022 updates
- COVID-19 Vaccine Provider Incentive program ages 5+
May 2022 Anthem Provider News - Kentucky Medicaid May 1, 2022

Provider Pathways eLearning is here!

May 2022 Anthem Provider News - Kentucky Medicaid May 1, 2022

Reimbursement policy update: Corrected Claims

May 2022 Anthem Provider News - Kentucky Medicaid May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Anthem Provider News - Kentucky Medicaid May 1, 2022

Keep up with Medicare News - May 2022

- Anthem expands specialty pharmacy precertification list-March 2022 update
- Anthem expands specialty pharmacy precertification list-April 2022 update
- New specialty pharmacy medical step therapy requirements-May 2022 update
May 2022 Anthem Provider News - Kentucky Medicare May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Provider News - Kentucky Medicare May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Anthem Provider News - Kentucky Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements-March 2022 update

May 2022 Anthem Provider News - Kentucky Medicare May 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP Quality Reimbursement Program for PPO providers

May 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) May 1, 2022

Join us for an FEP Quality Learning Program live webinar

May 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) May 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

Keep up with Medicaid News - April 2022

- Botox update for Anthem Medicaid members
- Prior authorization required for specialty pharmacy drugs
- New specialty pharmacy medical step therapy requirements
April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

Get faster payments with EFT

April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

Cancer Care Navigator

April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

Getting tobacco users the help they need to quit

April 2022 Anthem Provider News - Kentucky Medicaid Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Keep up with Medicare News - April 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Anthem expands specialty pharmacy precertification list
April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Get faster payments with EFT

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Reimbursement policy update: Inpatient readmissions

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

The impact of listening

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Model of Care required training

April 2022 Anthem Provider News - Kentucky Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date. Read important information about this change here.
Transition to NYC Medicare Advantage Plus Delayed - Kentucky Medicare Mar 15, 2022

Change to the Federal Employee Program clinical grievance and appeal address

March 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Mar 1, 2022

Keep up with Medicaid News - March 2022

- Medical drug benefit clinical criteria updates
- InterQual 2021.1 revisions
- Prior authorization updates for medications billed under the medical benefit
March 2022 Anthem Provider News - Kentucky Medicaid Mar 1, 2022

It is CAHPS survey time!

March 2022 Anthem Provider News - Kentucky Medicaid Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Anthem Provider News - Kentucky Medicaid Mar 1, 2022

Changes to precertification

March 2022 Anthem Provider News - Kentucky Medicaid Mar 1, 2022

Keep up with Medicare News - March 2022

- Medical step therapy updates
March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

HEDIS 2022 Federal Employee Program medical record request requirements

March 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Mar 1, 2022

Annual wellness visits for Medicare Advantage members

March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

Pharmacy: Medication adherence

March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

Evaluation and management services correct coding reminder (professional)

March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

Clinical criteria updates

March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

Provider notification for utilization management authorization rule operations workgroup item 2662

March 2022 Anthem Provider News - Kentucky Medicare Mar 1, 2022

Keep up with Medicaid News - February 2022

- COVID-19 Vaccine Provider Incentive program ages 5 to 11
February 2022 Anthem Provider News - Kentucky Medicaid Feb 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

February 2022 Anthem Provider News - Kentucky Medicaid Feb 1, 2022

Clinical criteria updates

February 2022 Anthem Provider News - Kentucky Medicaid Feb 1, 2022
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