New York
Provider Communications

February 2021 Empire Provider News

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Title Category

Procedure Searches in Find Care - New Sort Option

Administrative

New provider directory indicator for telehealth services

Administrative

Prior authorization requirements for 55899

Medicaid

Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326

Medicaid

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

Medicaid

New specialty pharmacy medical step therapy requirements

Medicaid

Colorectal Cancer Screening (COL) - ensuring quality of care

Medicaid

CAHPS® survey

Medicaid

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

Medicaid

Medical drug benefit Clinical Criteria updates

Medicaid

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

Medicaid

Keep up with Medicaid news

Medicaid

Medical drug benefit Clinical Criteria updates

Medicare

Keep up with Medicare news

Medicare

Prior authorization updates for specialty pharmacy are available

Material Adverse Change (MAC) Notification
Pharmacy

Empire to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

Emergency Room Transfers (Facility)

Material Adverse Change (MAC) Notification
Reimbursement Policies

Treatment Rooms with Office Evaluation and Management Services (Facility)

Material Adverse Change (MAC) Notification
Reimbursement Policies
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