CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsSeptember 1, 2024

September 2024 Provider Newsletter

Featured Articles

AdministrativeCommercialMedicare AdvantageAugust 1, 2023

Clinical Laboratory Improvement Amendments

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 28, 2024

Maximizing care with regular provider data attestation


Administrative

AdministrativeBadgerCare Plus and Medicaid SSI ProgramsSeptember 1, 2024

Enhanced claims edits for FDA-approved drug codes

AdministrativeMedicare AdvantageSeptember 1, 2024

Drug and biologic

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 28, 2024

Advancing digital efficiency by discontinuing paper remittances

Digital SolutionsMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 13, 2024

Coming soon — digital-only authorization case status notifications

Education & Training

Education & TrainingCommercialSeptember 1, 2024

New provider resource for family caregivers of members with cancer

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsJuly 23, 2024

Clinical Criteria updates

Effective August 25, 2024

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsAugust 13, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective September 15, 2024

Medical Policy & Clinical GuidelinesCommercialAugust 14, 2024

Medical Policies and Clinical UM Guidelines updates — September 2024

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsAugust 5, 2024

Prior authorization requirement changes

Effective October 1, 2024
Codes: 33263, 33264, 64582, C2616, and S2095

Prior AuthorizationMedicare AdvantageJuly 31, 2024

Prior authorization requirement changes

Effective December 1, 2024

Products & Programs

Federal Employee Program (FEP)CommercialJuly 31, 2024

FEP Quality Reimbursement Program for providers

Long-Term Services & SupportsCommercialSeptember 1, 2024

The Power of the Blues: Introducing the Blue National Physician Performance Dataset

PharmacyCommercialAugust 26, 2024

Specialty pharmacy updates — September 2024

PharmacyMedicare AdvantageSeptember 1, 2024

Real-time prescription benefit

PharmacyMedicare AdvantageAugust 12, 2024

Anthem expands specialty pharmacy precertification list

Code: J1599

PharmacyMedicare AdvantageAugust 27, 2024

Anthem expands specialty pharmacy precertification list

Codes: C9399, J9999 and J3590

PharmacyCommercialSeptember 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageAugust 13, 2024

Announcing the new HEDIS documentation library supporting coding excellence

WIBCBS-CDCRCM-065323-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).