CommercialJune 1, 2022

June 2022 Newsletter

Administrative

AdministrativeCommercialMay 31, 2022

Provider outreach to validate your provider data

AdministrativeCommercialMay 31, 2022

Evaluation and management services for COVID testing - professional

Material adverse change (MAC)

AdministrativeCommercialMay 31, 2022

Exploring the Intersection of Race and Disability

AdministrativeCommercialMay 31, 2022

CAA: Provider directories accuracy is important

Behavioral Health

Behavioral HealthCommercialMay 31, 2022

Opioid overdose deaths: What can we do?

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 31, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialMay 31, 2022

Updates to AIM Specialty Health musculoskeletal clinical appropriateness guidelines
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialMay 31, 2022

Updates to AIM Specialty Health sleep disorder management clinical appropriateness

Material Adverse Change (MAC)

Reimbursement PoliciesCommercialMay 31, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (Facility)

Material Adverse Change (MAC)

Products & Programs

Federal Employee Program (FEP)CommercialMay 31, 2022

Process change for Federal Employee Program® third-party correspondence requests

PharmacyCommercialMay 31, 2022

Specialty pharmacy updates - June 2022
Material Adverse Change (MAC)

State & Federal

State & FederalMedicaidMay 31, 2022

Provider notice for COVID-19 testing

State & FederalMedicaidMay 31, 2022

InterQual migration

State & FederalMedicaidMay 31, 2022

Keep up with Medicaid news- June 2022

View these Medicaid articles:

  • Prior authorization update for select durable medical equipment (DME) items
  • Prior authorization updates for medications billed under the medical benefit
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • Medical drug benefit Clinical Criteria updates

State & FederalMedicare AdvantageMay 31, 2022

Provider notice for COVID-19 testing

State & FederalMedicare AdvantageMay 31, 2022

Medical drug benefit Clinical Criteria updates

State & FederalMedicare AdvantageMay 31, 2022

Medical Policies and Clinical Utilization Management Guidelines update

State & FederalMedicare AdvantageMay 31, 2022

Keep up with Medicare news - June 2022

View these Medicare articles:

  • New specialty pharmacy medical step therapy requirements
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines