New York
Provider Communications

February 2020 Empire Provider News

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Title Category

Clinical Criteria updates for specialty pharmacy are available

Pharmacy

Clinical Laboratory Improvements Amendments for Empire

Reimbursement Policies

Empire SOAP Notes/Health Assessments for 2019 calendar year are due February 15, 2020

Administrative

Empire to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

General Building Laborers' Local 66 Welfare Fund offers Medicare Advantage option

Medicare

Keep up with Medicaid news

Medicaid

Keep up with Medicare news

Medicare

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical Guidelines

Medicare Advantage Outpatient Rehabilitation Program transition information

Medicare

Non-covered codes for Medicaid Managed Care (MMC) providers

Medicaid

NYSHIP (New York State Health Insurance Program) change in immunization claim submissions

Administrative

Pharmacy Prior Authorization processing to transition to Empire's Pharmacy Benefit Manager: IngenioRx, Inc.

Pharmacy

Postponed - Review of professional claims with emergency room level 5 E/M codes

Medicare

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) (Effective 05/01/20)

Medicaid

Reimbursement Policy Update: Modifier 62: Co-Surgeons (Effective 05/01/2020)

Medicare

Reimbursement Policy Update: Multiple and Bilateral Surgery: Professional and Facility Reimbursement (Policy 06-010, effective 05/01/20)

Medicare

Resources to support your diverse patient panel

Medicaid

Shine Light on Depression: school-based suicide prevention initiative

Behavioral Health

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines
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