CommercialNovember 1, 2020

November 2020 Empire Provider News

Administrative

AdministrativeCommercialOctober 31, 2020

Digital transactions cut administrative tasks in half

AdministrativeCommercialOctober 31, 2020

US Antibiotic Awareness Week

Policy Updates

Medical Policy & Clinical GuidelinesCommercialOctober 31, 2020

Clinical Guideline Updates
Material Adverse Change (MAC) notification

Medical Policy & Clinical GuidelinesCommercialOctober 31, 2020

Reminder: Post-service reviews using AIM

Reimbursement PoliciesCommercialOctober 31, 2020

Documentation Standards for Episodes of Care (Professional)
Material Adverse Change (MAC) notification

Reimbursement PoliciesCommercialOctober 31, 2020

Modifier Rules (Professional)
Material Adverse Change (MAC) notification

Reimbursement PoliciesCommercialOctober 31, 2020

Bundled Services and Supplies (Professional)
Material Adverse Change (MAC) notification

Products & Programs

Products & ProgramsCommercialOctober 31, 2020

Reminder: Specialty Pharmacy Program expands Level of Care Reviews to NYC Hospital PPO Members
Material Adverse Change (MAC) notification

PharmacyCommercialOctober 31, 2020

Prior authorization updates for specialty pharmacy are available
Material Adverse Change (MAC) notification

PharmacyCommercialOctober 31, 2020

IngenioRx Introduces New Pharmacy Network in 2021

PharmacyCommercialOctober 31, 2020

Clinical Criteria updates for specialty pharmacy are available
Material Adverse Change (MAC) notification

State & Federal

State & FederalMedicaidOctober 31, 2020

Keep up with Medicaid news

State & FederalMedicaidOctober 31, 2020

Medical drug benefit Clinical Criteria updates

State & FederalMedicaidOctober 31, 2020

Coding spotlight: tips and best practices for compliance

State & FederalMedicaidOctober 31, 2020

Inhaled nitric oxide reviews for diagnosis-related group admissions

State & FederalMedicaidOctober 31, 2020

Provider transparency update

State & FederalMedicaidOctober 31, 2020

New specialty pharmacy medical step therapy requirements (Avastin)

State & FederalMedicare AdvantageOctober 31, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

State & FederalMedicare AdvantageOctober 31, 2020

Provider Chat — A fast, easy way to get your questions answered

State & FederalMedicare AdvantageOctober 31, 2020

Medical drug benefit Clinical Criteria updates

State & FederalMedicare AdvantageOctober 31, 2020

FDA approvals and expedited pathways used — new molecular entities

State & FederalMedicare AdvantageOctober 31, 2020

Preferred continuous glucose monitors

State & FederalMedicare AdvantageOctober 31, 2020

Keep up with Medicare news

State & FederalMedicaidOctober 31, 2020

Attention: Updated laboratory fee schedule

State & FederalMedicaidOctober 31, 2020

Digital transactions cut administrative tasks in half