Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- January 2020

Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.

 

Medical Policies/Clinical Guidelines

• Important Update: Milliman Care Guideline [MCG], 23rd Edition (MAC)

 

Reimbursement Policies

• Outpatient Facility Edit Implementation (MAC)

 

Other Important Updates

• Medicare and Medicaid News