CommercialMedicare AdvantageMedicaidMay 2, 2023
May 2023 Provider News
Administrative
CommercialMay 1, 2023
Moving Toward Equity in Asthma CareCommercialMay 1, 2023
Drug fee schedule updateCommercialMedicare AdvantageMay 1, 2023
Looking to earn CME credits? Check out the CME Engagement Hub!CommercialMedicare AdvantageMay 1, 2023
You are invited! Skilled Nursing Facility (SNF) providers: Fall prevention and patient safetyCommercialMay 1, 2023
Consolidated Appropriations Act: Review your online provider directory information regularlyCommercialMedicare AdvantageMedicaidMay 1, 2023
Enhanced Provider News website and email communications launching May 1Policy Updates
CommercialMedicaidMay 1, 2023
Introducing www.myhealthbenefitfinder.comCommercialMay 1, 2023
Material adverse change
Transition to Carelon Medical Benefits Management, Inc.* MRI Breast Clinical Appropriateness GuidelinesCommercialMay 1, 2023
New Reimbursement policy: Bundled Supplies and Services - Facility (MAC)Material adverse change (MAC)
CommercialMay 1, 2023
Material adverse change
Reimbursement policy update: Robotic Assisted Surgery – Professional (MAC)CommercialMay 1, 2023
Material adverse change
Reimbursement policy update: Multiple and Bilateral Surgery Processing - ProfessionalProducts & Programs
State & Federal
MedicaidMay 1, 2023
Keep up with Medicaid news- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Alymsys)
- New specialty pharmacy medical step therapy requirements (Zarxio, Granix, Neupogen, Nivestym, Releuko)
- HPV vaccine standing order and parent conversations
- Moving Toward Equity in Asthma Care CME Training and Asthma Medication Ratio HEDIS measure update
Medicare AdvantageMay 1, 2023
Did your patient have a recent fracture?Medicare AdvantageMay 1, 2023
Genetic testingMedicare AdvantageMay 1, 2023
Update: Authorizations for DMEPOS services for Medicare Advantage Individual, Group Retiree Solutions, and Dual-Eligible plan membersMedicare AdvantageMay 1, 2023
Keep up with Medicare newsNVBCBS-CDCRCM-023176-23
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
* Availity, LLC is an independent company providing administrative support services on behalf of the health plan.
* Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan.
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