New York
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

HEDIS 2022: Summary of changes from NCQA

August 2022 Newsletter Medicaid Aug 1, 2022

Chlamydia screening

August 2022 Newsletter Medicaid Aug 1, 2022

Using SBIRT to address opioid and substance use disorders

August 2022 Newsletter Medicaid Aug 1, 2022

The cost of alcohol use disorder

August 2022 Newsletter Medicaid Aug 1, 2022

Prior authorization requirement changes updated effective date November 1, 2022

August 2022 Newsletter Medicaid Aug 1, 2022

Prior authorization requirement changes effective August 1, 2022

July 2022 Newsletter Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Newsletter Medicaid Jul 1, 2022

Update to electronic verification visit key points

July 2022 Newsletter Medicaid Jul 1, 2022

Provider reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Counseling program

July 2022 Newsletter Medicaid Jul 1, 2022

Keep up with Medicaid news- July 2022

View these Medicaid articles:

  • Three-point match verification for professional claims payment
  • Prior authorization updates for medications billed under the medical benefit
  • Updates for medication codes billed under the medical benefit
July 2022 Newsletter Medicaid Jul 1, 2022

Provider notice for COVID-19 testing

June 2022 Newsletter Medicaid Jun 1, 2022

InterQual migration

June 2022 Newsletter Medicaid Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Newsletter Medicaid Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Newsletter Medicaid Jun 1, 2022

Keep up with Medicaid news- June 2022

View these Medicaid articles:

  • Prior authorization update for select durable medical equipment (DME) items
  • Prior authorization updates for medications billed under the medical benefit
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • Medical drug benefit Clinical Criteria updates
June 2022 Newsletter Medicaid Jun 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Newsletter Medicaid May 1, 2022

New Strategic Provider System implementation May 2022

May 2022 Newsletter Medicaid May 1, 2022

CPT Category II update

May 2022 Newsletter Medicaid May 1, 2022

Keep up with Medicaid news- May 2022

View these Medicaid articles:

  • Prior authorization requirement changes for HCPCS code K1022
  • New specialty pharmacy medical step therapy requirements
May 2022 Newsletter Medicaid May 1, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Medicaid Apr 1, 2022

Syphilis, including congenital cases, on the rise in New York

April 2022 Newsletter Medicaid Apr 1, 2022

Reimbursement Policy Update: Inpatient Readmissions

April 2022 Newsletter Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Newsletter Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Newsletter Medicaid Apr 1, 2022

Keep up with Medicaid news – April 2022

View these Medicaid articles:

  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
  • Prior authorization updates for medications billed under the medical benefit
  • Medical drug benefit Clinical Criteria updates
  • Medical Policies and Clinical Utilization Management Guidelines update
April 2022 Newsletter Medicaid Apr 1, 2022

Required: Cultural competence training

March 2022 Newsletter Medicaid Mar 1, 2022

It is CAHPS survey time!

March 2022 Newsletter Medicaid Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Newsletter Medicaid Mar 1, 2022

New Strategic Provider System will launch in April 2022

March 2022 Newsletter Medicaid Mar 1, 2022

Get faster payments with EFT

February 2022 Newsletter Medicaid Feb 1, 2022

Botox update for Empire BlueCross BlueShield HealthPlus members

January 2022 Newsletter Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Newsletter Medicaid Jan 1, 2022

2021 CAHPS Survey results

January 2022 Newsletter Medicaid Jan 1, 2022

Keep up with Medicaid news - January 2022

View these Medicaid articles:

  • AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
    update
  • Prior authorization updates for medications billed under the medical
    benefit
January 2022 Newsletter Medicaid Jan 1, 2022

Reimbursement policy update: Drug Screen Testing (effective March 1, 2022)

December 2021 Newsletter Medicaid Dec 1, 2021

Reimbursement policy update: Multiple and Bilateral Surgery - Professional and Facility (effective 03/01/22)

December 2021 Newsletter Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Drug Dependency

December 2021 Newsletter Medicaid Dec 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

December 2021 Newsletter Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

December 2021 Newsletter Medicaid Dec 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

December 2021 Newsletter Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Newsletter Medicaid Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Newsletter Medicaid Dec 1, 2021

Keep up with Medicaid news - December 2021

View these Medicaid articles:

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Cancer Care Navigator
  • Medical drug benefit Clinical Criteria updates
  • Prior authorization updates for medications billed under the medical
    benefit
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
December 2021 Newsletter Medicaid Dec 1, 2021

New York state Medicaid expansion of coverage for colorectal cancer screening

November 2021 Newsletter Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Newsletter Medicaid Nov 1, 2021

Clinical Criteria updates

November 2021 Newsletter Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Newsletter Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your women patients

November 2021 Newsletter Medicaid Nov 1, 2021

Keep up with Medicaid news - November 2021

View these Medicaid articles:
  • Medicaid continuous glucose monitoring systems
  • Prior authorization updates for specialty pharmacy
November 2021 Newsletter Medicaid Nov 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Newsletter Medicaid Oct 1, 2021

Diabetes testing and screening HEDIS measures

October 2021 Newsletter Medicaid Oct 1, 2021

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

October 2021 Newsletter Medicaid Oct 1, 2021

FAQ: Update to AIM phone number

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy IV

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy V

October 2021 Newsletter Medicaid Oct 1, 2021

Keep up with Medicaid news - October 2021

View these Medicaid articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Newsletter Medicaid Oct 1, 2021

Keep up with Medicaid news - September 2021

View these Medicaid article: 
  • Clinical Criteria Updates Notification May 2021
  • Iron Infusion Step Therapy
  • Iron Infusion Prior Authorization Update
September 2021 Newsletter Medicaid Sep 1, 2021

Keep up with Medicaid news

August 2021 Newsletter Medicaid Aug 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients

July 2021 Newsletter Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Newsletter Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)

July 2021 Newsletter Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Newsletter Medicaid Jul 1, 2021

Certain specialty medication precertification requests may require additional documentation

July 2021 Newsletter Medicaid Jul 1, 2021

Medical drug benefit Clinical Criteria updates

July 2021 Newsletter Medicaid Jul 1, 2021

Retraction: AIM Rehabilitative program — initial evaluations and site of service reviews

July 2021 Newsletter Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal program clinical appropriateness guidelines

July 2021 Newsletter Medicaid Jul 1, 2021

Coding spotlight: mental disorders in childhood

July 2021 Newsletter Medicaid Jul 1, 2021

What Matters Most: Improving the Patient Experience

July 2021 Newsletter Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Newsletter Medicaid Jul 1, 2021

Keep up with Medicaid news

July 2021 Newsletter Medicaid Jul 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Newsletter Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Newsletter Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Newsletter Medicaid Jun 1, 2021

Complex Case Management program

June 2021 Newsletter Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Newsletter Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Newsletter Medicaid Jun 1, 2021

Keep up with Medicaid news

June 2021 Newsletter Medicaid Jun 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Newsletter Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Newsletter Medicaid May 1, 2021

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines

May 2021 Newsletter Medicaid May 1, 2021

Continuing medical education/continuing education unit opportunities

May 2021 Newsletter Medicaid May 1, 2021

Keep up with Medicaid news

May 2021 Newsletter Medicaid May 1, 2021

Keep up with Medicaid news

April 2021 Newsletter Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

March 2021 Empire Provider News Medicaid Mar 1, 2021

MCG Care Guidelines 24th edition customization

March 2021 Empire Provider News Medicaid Mar 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

March 2021 Empire Provider News Medicaid Mar 1, 2021

Ocrevus/Vyepti Medical Step Therapy Notice

March 2021 Empire Provider News Medicaid Mar 1, 2021

Prior authorization requirements for 55899

February 2021 Empire Provider News Medicaid Feb 1, 2021

Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326

February 2021 Empire Provider News Medicaid Feb 1, 2021

Updated AIM Rehabilitative program effective August 1, 2021 - Initial evaluations and site of care reviews

February 2021 Empire Provider News Medicaid Feb 1, 2021

New specialty pharmacy medical step therapy requirements

February 2021 Empire Provider News Medicaid Feb 1, 2021

Colorectal Cancer Screening (COL) - ensuring quality of care

February 2021 Empire Provider News Medicaid Feb 1, 2021

CAHPS® survey

February 2021 Empire Provider News Medicaid Feb 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Empire Provider News Medicaid Feb 1, 2021

Medical drug benefit Clinical Criteria updates

February 2021 Empire Provider News Medicaid Feb 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards

February 2021 Empire Provider News Medicaid Feb 1, 2021

Keep up with Medicaid news

February 2021 Empire Provider News Medicaid Feb 1, 2021

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging

January 2021 Empire Provider News Medicaid Jan 1, 2021

FDA approvals and expedited pathways used — new molecular entities (NMEs)

January 2021 Empire Provider News Medicaid Jan 1, 2021
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