New York
Provider Communications

April 2022 Newsletter

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Title Category

CAA: Update your provider directory information

Administrative

Catching up on routine vaccines

Administrative

Clinical Criteria updates

Medicaid

Clinical Criteria updates

Medicare

Disease Management/Population Health program

Medicaid

HEDIS 2022: Summary of changes from NCQA

Administrative

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

Medicare

Importance of behavioral healthcare after-hours messaging

Behavioral Health

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
Medicaid

Keep up with Medicare news – April 2022

View these Medicare articles:

  • Medical Policies and Clinical Utilization Management Guidelines update
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
Medicare

Model of Care required training

Medicare

Pharmacy information available on empireblue.com

Pharmacy

Procedure searches in Find Care

Digital Tools

Reimbursement Policy Update: Inpatient Readmissions

Medicaid

Reimbursement Policy Update: Inpatient Readmissions

Medicare

Reminder on Botox® for Empire members

Pharmacy

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

Federal Employee Plan (FEP)

Specialty pharmacy updates - April 2022

Material Adverse Change (MAC)

Pharmacy

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

Medicaid

The Anthem, Inc. name is changing

Administrative

The Anthem, Inc. name is changing

Medicaid

The Anthem, Inc. name is changing

Medicare

The impact of listening

Medicare
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