Recent Updates
Medicare AdvantageJanuary 8, 2025
Follow‑up After Emergency Department Visit for Patients With Multiple High‑Risk Chronic Conditions (FMC) 2025Medicare AdvantageJanuary 7, 2025
Advanced Illness and Frailty 2025Medicare AdvantageJanuary 6, 2025
Adult Immunization Status (AIS‑E) 2025Medicare AdvantageDecember 31, 2024
Important information about specialty prescriptionsMedicare AdvantageDecember 30, 2024
Kroger Specialty Pharmacy acquisitionMedicare AdvantageDecember 30, 2024
Enhance patient coordination with Total Member ViewMedicare AdvantageDecember 23, 2024
Specialty pharmacy precertification list expansionMedicare AdvantageDecember 23, 2024
Specialty Pharmacy Precertification and Step Therapy list expansionEffective April 1, 2025
Medicare AdvantageDecember 19, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesMedicare AdvantageDecember 16, 2024
Shortage of repackaged bevacizumab for ophthalmic useMedicare AdvantageDecember 4, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective January 5, 2024
Medicare AdvantageNovember 26, 2024
HEDIS Category II Coding Bulletin 2025Medicare AdvantageNovember 19, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Medicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025Medicare AdvantageOctober 25, 2024
Time to prepare for HEDIS medical record reviewMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025Medicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025Medicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicare AdvantageOctober 16, 2024
Carelon Medical Benefits Management, Inc. updatesEffective November 17, 2024
Medicare AdvantageOctober 15, 2024
You are invited: real-time prescription benefit webinarMedicare AdvantageOctober 14, 2024
Save time with new CPT code search functionalityMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 6, 2024
Improving patient outcomes: back to the basicsMedicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025Medicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
You are invited: Annual planned visits for Medicare patients webinarMedicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025Medicare AdvantageOctober 1, 2024
County of Delaware launches Blue Medicare Advantage PPO plan for retirees in 2025Medicare AdvantageSeptember 24, 2024
Prior authorization requirement changesEffective February 1, 2025
Medicare AdvantageSeptember 23, 2024
Prior authorization requirement changesEffective January 1, 2025
Medicare AdvantageSeptember 23, 2024
Osteoporosis Management in Women Who Had a Fracture (OMW) 2025Medicare AdvantageSeptember 19, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Medicare AdvantageSeptember 19, 2024
HEDIS Measure Tips — Osteoporosis Screening in Older Women (OSW) 2025Medicare AdvantageSeptember 10, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective October 10, 2024
Medicare AdvantageAugust 28, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageAugust 27, 2024
BMA expands specialty pharmacy precertification listCodes: C9399, J9999 and J3590
Medicare AdvantageAugust 22, 2024
Advancing digital efficiency by discontinuing paper remittancesMedicare AdvantageAugust 20, 2024
Drug and biologicMedicare AdvantageAugust 13, 2024
Announcing the new HEDIS documentation library supporting coding excellenceMedicare AdvantageAugust 12, 2024
BMA expands specialty pharmacy precertification listMedicare AdvantageAugust 9, 2024
Real-time prescription benefitMedicare AdvantageAugust 8, 2024
You are invited: HEDIS immunization measures: strategies for improving performanceMedicare AdvantageAugust 8, 2024
Digital-only authorization case status notification coming to you