Kentucky
Provider Communications

Articles Category: State & Federal / Medicaid

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 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

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 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

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 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 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

Reimbursement policy update: Inpatient Readmissions

June 2022 Anthem Provider News - Kentucky Medicaid 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

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

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 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

The Behavioral Health Areas of Expertise Profile improves the referral process

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

2021 CAHPS survey results

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

Keep up with Medicaid News - January 2022

- New department for Medicaid services MAP form available for providers
- Cancer Care Navigator
- Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines
- Medical Policies and Clinical Utilization Management Guidelines update
- Specialty pharmacy site of care
- Prior authorization updates for medications billed under the medical benefit
January 2022 Anthem Provider News - Kentucky Medicaid Jan 1, 2022

Unspecified diagnosis reminder

January 2022 Anthem Provider News - Kentucky Medicaid Jan 1, 2022

Keep up with Medicaid News - December 2021

  • Prior authorization updates for specialty pharmacy effective December 1, 2021
  • Prior authorization updates for specialty pharmacy effective January 1, 2022
December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

COVID-19 Vaccine Provider Incentive program

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

4 things you can do to encourage cancer screenings for your female patients

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

Keep up with Medicaid News - November 2021

View these Medicaid articles:
- March 2021 Medical drug benefit Clinical Criteria updates
- May 2021 Medical drug benefit Clinical Criteria updates
November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Get your payments faster when you sign up for electronic funds transfer

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Diabetes testing and screening HEDIS measures

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

May 2021 medical policies and utilization management guidelines update

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

2021 affirmative statement concerning utilization management decisions

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

Appointment availability and after-hours access requirements

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

Keep up with Medicaid news  - September 2021

View this Medicaid article:
- Clinical criteria web posting May 2020
September 2021 Anthem Provider News - Kentucky Medicaid Sep 1, 2021

Medicaid News - August 2021

View these Medicaid articles:
- InterQual April 2021 revisions
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1837
August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

March 2020 medical drug benefit clinical criteria updates

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

June 2020 medical drug benefit clinical criteria updates

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

New reimbursement policy: Modifier 90 Reference (Outside) Laboratory and Pass-Through Billing effective November 1, 2021

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Keeping up with routine vaccination during COVID-19

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Resources to support your diverse patient panel

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Coding spotlight: mental disorders in childhood

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Complex case management program

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Important information about utilization management

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Member rights’ and responsibilities statement

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Medicaid News - July 2021

View these Medicaid articles:
- Aspire Health for members in need of palliative care
- Clinical criteria updates notification December 2020
July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

What Matters Most: Improving the Patient Experience

July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

Medicaid News - June 2021

View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Medical drug benefit clinical criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Kentucky Medicaid Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Anthem Provider News - Kentucky Medicaid Jun 1, 2021

Important Crib and Car Seat Program update

June 2021 Anthem Provider News - Kentucky Medicaid Jun 1, 2021

Medicaid news - May 2021

View these Medicaid articles:
- Clinical criteria updates notification November 2020
- Update to claim filing limit
May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Continuing medical education and continuing education unit opportunities

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Sign up to receive email from Anthem Blue Cross and Blue Shield Medicaid

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Medical drug benefit clinical criteria updates - April 2021

April 2021 Anthem Provider News - Kentucky Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

April 2021 Anthem Provider News - Kentucky Medicaid Apr 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Prior authorization required for radiotherapies and radioimmunotherapies effective March 1, 2021

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Prior authorization requirement changes effective April 1, 2021

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Medicaid News - February 2021

View these Medicaid articles:
- InterQual 2020.1 update
- New specialty pharmacy medical step therapy requirements-1
- New specialty pharmacy medical step therapy requirements-2
- Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging
- Sign up to receive email from Anthem Blue Cross and Blue Shield Medicaid
February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

CAHPS® survey

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

FDA approvals and expedited pathways used - new molecular entities (NMEs)

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

New specialty pharmacy medical step therapy requirements

January 2021 Anthem Provider News - Kentucky Medicaid Jan 1, 2021

New specialty pharmacy medical step therapy requirements

January 2021 Anthem Provider News - Kentucky Medicaid Jan 1, 2021

Disease Management/Population Health program

January 2021 Anthem Provider News - Kentucky Medicaid Jan 1, 2021
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