CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsDecember 1, 2024

December 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

Roster Automation updates: roster download functionality


Administrative

AdministrativeMedicare AdvantageNovember 18, 2024

Wisconsin 2025 Medicare Advantage plan changes

AdministrativeCommercialDecember 1, 2024

Case Management program

AdministrativeCommercialDecember 1, 2024

PCP after‑hours access requirements

AdministrativeCommercialDecember 1, 2024

Coordination of care

AdministrativeMedicare AdvantageDecember 1, 2024

Wisconsin Sheet Metal Workers Health and Benefit Fund moves to Anthem

AdministrativeCommercialDecember 1, 2024

Clinical practice and preventive health guidelines available online

AdministrativeCommercialDecember 1, 2024

Important information about utilization management

AdministrativeMedicare AdvantageNovember 15, 2024

Skilled nursing facility — vaccine serum compensation

AdministrativeCommercialDecember 1, 2024

Members’ Rights and Responsibilities

Digital SolutionsMedicare AdvantageNovember 18, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Behavioral Health

Behavioral HealthMedicare AdvantageDecember 1, 2024

Comprehensive, holistic care for obstructive sleep apnea

Education & Training

Education & TrainingMedicare AdvantageNovember 18, 2024

Notice of change: Part D Rx HCCs

Policy Updates

Policy UpdatesMedicare AdvantageOctober 30, 2024

Clinical Criteria updates

Effective December 2, 2024

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsNovember 7, 2024

Clinical Criteria updates

Effective December 11, 2024

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsNovember 15, 2024

Clinical Criteria updates

Effective December 18, 2024

Reimbursement PoliciesCommercialDecember 1, 2024

Material adverse change

New reimbursement policy: Trauma Activation — Facility

Products & Programs

Products & ProgramsCommercialNovember 21, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Federal Employee Program (FEP)CommercialDecember 1, 2024

FEP excited to join PSHB program in 2025

PharmacyCommercialDecember 1, 2024

Pharmacy information available online

PharmacyCommercialDecember 1, 2024

Kroger Specialty Pharmacy acquisition

PharmacyCommercialNovember 18, 2024

Material adverse change

Specialty pharmacy updates — December 2024

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