Important News

We have collected and categorized the most recent policy updates, product updates, and company information that may be useful to you.

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Expansion of Medicare Part B Step Therapy and Prior Authorization Requirements

2023-01-11 -

Documentation and Coding for Bipolar, Delusional & Personality Disorders

2023-01-11 -

New specialty pharmacy medical step therapy requirements (Healthy Blue + Medicare HMO D-SNP)

2022-12-28 -

Medical Policies and Clinical Utilization Management Guidelines Update (Healthy Blue + Medicare HMO D-SNP)

2022-12-28 -

Measurement Year 2023 MA QIP Policy Update

2022-12-20 -

HEDIS Measurement Year 2022 Medical Record Review begins in February

2022-12-12 -

Specialty Pharmacy Precertification List Expansion (Healthy Blue + Medicare HMO D-SNP)

2022-12-12 -

Specialty Pharmacy Precertification List Expansion Effective April 1 (Healthy Blue + Medicare HMO D-SNP)

2022-12-12 -

Prior Authorization Requirement Changes Effective April 1, 2023 (Healthy Blue + Medicare HMO D-SNP)

2022-12-12 -

Provider Training Session for the Enhanced Cardiology Program with AIM Specialty Health

2022-12-09 -

Specialty pharmacy precertification list expansion (Healthy Blue + Medicare HMO D-SNP)

2022-12-08 -

New Specialty Pharmacy Medical Step Therapy Requirements (Healthy Blue + Medicare HMO D-SNP)

2022-12-06 -

Medicare Advantage – Prior authorization requirement changes effective (Healthy Blue + Medicare HMO D-SNP) March 1, 2023

2022-12-01 -

Update – NCQA Survey for PCPs, Oncologists and OB-GYNs

2022-11-29 -

Reminder for Place of Service and Durable Medical Equipment

2022-11-23 -

Enhanced Editing Affecting Drugs & Biological Agents

2022-11-23 -

Update - Evaluation and Management (E&M) Claims Reprocessing

2022-11-23 -

IngenioRx will become CarelonRx on January 1, 2023 (Healthy Blue + Medicare HMO D-SNP)

2022-11-21 -

Prior Authorization Requirement Changes (Healthy Blue + Medicare HMO D-SNP)

2022-11-21 -

June 2022 Clinical Criteria Updates (Healthy Blue + Medicare HMO D-SNP)

2022-11-21 -

Clinical Criteria Updates (Healthy Blue + Medicare HMO D-SNP)

2022-11-21 -

Preferred Intra-Articular Hyaluronan Knee Injection Treatment

2022-11-21 -

Medicare Part B Precert Expansion Cimerli (Healthy Blue + Medicare HMO D-SNP)

2022-11-21 -

Additional Information About the Telehealth Policy for 2023

2022-11-14 -

Additional Information Regarding Evaluation and Management Related Services Recoupment

2022-11-09 -

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