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Title	Publication	Category	Date
Update to Claim Payment Dispute process Material Adverse Change (MAC)	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Medical Oncology Program ProviderPortal case entry enhancements	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023 Material Adverse Change (MAC)	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Update use of modifier 25 for billing for visits that include preventive and problem-oriented evaluation and management services	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Helping to reduce delays when submitting attachments	April 2023 Provider News - New York	Administrative	Mar 31, 2023
CAA: Maintain your online provider directory information	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)* Material Adverse Change (MAC)	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures	April 2023 Provider News - New York	Administrative	Mar 31, 2023
Submitting prior authorizations is getting easier	April 2023 Provider News - New York	Digital Tools	Mar 31, 2023
Survey for all skilled nursing facilities	April 2023 Provider News - New York	Digital Tools	Mar 31, 2023
Notification Regarding Reimbursement Changes to COVID-19 Vaccine Administration Material Adverse Change (MAC)	April 2023 Provider News - New York	Reimbursement Policies	Mar 31, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional	April 2023 Provider News - New York	Reimbursement Policies	Mar 31, 2023
Bundled Services and Supplies - Professional Material Adverse Change (MAC)	April 2023 Provider News - New York	Reimbursement Policies	Mar 31, 2023
Let’s Vaccinate	April 2023 Provider News - New York	Products & Programs	Mar 31, 2023
Pharmacy information available on our provider website	April 2023 Provider News - New York	Pharmacy	Mar 31, 2023
Provider Pathways - Doing business with Empire BlueCross BlueShield HealthPlus (Empire) eLearning is here!	April 2023 Provider News - New York	Medicaid	Mar 31, 2023
Correct coding for hospital outpatient clinic visits for Medicaid	April 2023 Provider News - New York	Medicaid	Mar 31, 2023
Ready, set, renew!	April 2023 Provider News - New York	Medicaid	Mar 31, 2023
Keep up with Medicaid news - April 2023 View these Medicaid articles: Clinical Criteria updates New specialty pharmacy medical step therapy requirements (Repatha, Leqvio, Praluent)	April 2023 Provider News - New York	Medicaid	Mar 31, 2023
Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare Advantage	April 2023 Provider News - New York	Medicare	Mar 31, 2023
E-visits	April 2023 Provider News - New York	Medicare	Mar 31, 2023
IBEW Local 25, New York moves to the Retiree Solutions Medicare Advantage Plan from Empire BlueCross BlueShield	April 2023 Provider News - New York	Medicare	Mar 31, 2023
Keep up with Medicare news - April 2023 View these Medicare articles: Clinical Criteria updates Clinical Criteria updates Empire BlueCross BlueShield expands specialty pharmacy precertification list (Imjudo, Pedmark, Tecvayli, Tzield, Vegzelma) Empire BlueCross expands specialty pharmacy precertification list (Elahere) New specialty pharmacy medical step therapy requirements (Beovu, Macugen) Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)* Pay Doctor Bill (provider payment option) — General FAQ	April 2023 Provider News - New York	Medicare	Mar 31, 2023
HEDIS 2023 Federal Employee Program medical record request requirements	April 2023 Provider News - New York	Federal Employee Plan (FEP)	Mar 31, 2023
FEP Quality Reimbursement Program update	April 2023 Provider News - New York	Federal Employee Plan (FEP)	Mar 31, 2023
Federal Employee Program change for medical dental reimbursement Material Adverse Change (MAC)	FEP medical dental change	Federal Employee Plan (FEP)	Mar 9, 2023
Time to prepare for HEDIS medical record review	March 2023 Empire Provider News	Administrative	Mar 1, 2023
March is National Colorectal Cancer Awareness Month	March 2023 Empire Provider News	Administrative	Mar 1, 2023
Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update Material Adverse Change (MAC)	March 2023 Empire Provider News	Administrative	Mar 1, 2023
Notice of assignment of your Empire Provider Agreement to Carelon (formerly Beacon)	March 2023 Empire Provider News	Administrative	Mar 1, 2023
Advancing Mental Health Equity for Youth & Young Adults	March 2023 Empire Provider News	Administrative	Mar 1, 2023
Controlling High Blood Pressure and Submitting Compliant Readings	March 2023 Empire Provider News	Administrative	Mar 1, 2023
Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023	March 2023 Empire Provider News	Products & Programs	Mar 1, 2023
Policy Update: Modifiers 25 and 57 (Policy G-06003, effective 04/01/2023) Material Adverse Change (MAC)	March 2023 Empire Provider News	Medicaid	Mar 1, 2023
Reimbursement policy update: Modifiers 25 and 57 - Professional	March 2023 Empire Provider News	Reimbursement Policies	Mar 1, 2023
Specialty pharmacy updates for March 2023 Material adverse change (MAC)	March 2023 Empire Provider News	Pharmacy	Mar 1, 2023
Clinical Criteria updates for specialty pharmacy Material adverse change (MAC)	March 2023 Empire Provider News	Pharmacy	Mar 1, 2023
Pharmacy information available on our provider website	March 2023 Empire Provider News	Pharmacy	Mar 1, 2023
Keep up with Medicaid news - March 2023 View these Medicaid articles: Clinical Criteria updates Prior authorization updates for medications billed under the medical benefit (Carvykti) Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines	March 2023 Empire Provider News	Medicaid	Mar 1, 2023
Informational Update: Modifier Usage (Policy G-06006)	March 2023 Empire Provider News	Medicare	Mar 1, 2023
Shared savings and transition care management after inpatient discharges	March 2023 Empire Provider News	Medicare	Mar 1, 2023
Controlling High Blood Pressure and Submitting Compliant Readings	March 2023 Empire Provider News	Medicare	Mar 1, 2023
Keep up with Medicare news - March 2023 View these Medicare articles: Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update Clinical Criteria updates New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)	March 2023 Empire Provider News	Medicare	Mar 1, 2023
Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan	March 2023 Empire Provider News	Administrative	Feb 23, 2023
Notice of assignment of your Empire Provider Agreement to Beacon	Beacon Assignment	Administrative	Feb 13, 2023
AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.	February 2023 Newsletter	Administrative	Feb 1, 2023
New policy for clinical data sharing and ADT notifications Material Adverse Change (MAC)	February 2023 Newsletter	Administrative	Feb 1, 2023
Controlling High Blood Pressure and Submitting Compliant Readings	February 2023 Newsletter	Administrative	Feb 1, 2023
Have you reviewed your online provider directory information lately?	February 2023 Newsletter	Administrative	Feb 1, 2023
Participating provider contractual obligations: Advanced patient notice policy for non-participating provider referrals	February 2023 Newsletter	Administrative	Feb 1, 2023
Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements	February 2023 Newsletter	Digital Tools	Feb 1, 2023
Enhancing Provider News website and email communications	February 2023 Newsletter	Digital Tools	Feb 1, 2023
Medical Policy and Clinical Guideline updates Material Adverse Change (MAC)	February 2023 Newsletter	Medical Policy & Clinical Guidelines	Feb 1, 2023
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List	February 2023 Newsletter	Medical Policy & Clinical Guidelines	Feb 1, 2023
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	February 2023 Newsletter	Pharmacy	Feb 1, 2023
Specialty pharmacy updates - February 2023 Material Adverse Change (MAC)	February 2023 Newsletter	Pharmacy	Feb 1, 2023
Keep up with Medicaid news - February 2023 View these Medicaid articles:	February 2023 Newsletter	Medicaid	Feb 1, 2023
Mutual of America New York moves to the Empire BlueCross BlueShield retiree solutions Medicare Advantage plan	February 2023 Newsletter	Medicare	Feb 1, 2023
City of Manchester Offers Medicare Advantage Option	February 2023 Newsletter	Medicare	Feb 1, 2023
Keep up with Medicare news - February 2023 View these Medicare articles: Introducing the Provider Learning Hub Empire BlueCross expands specialty pharmacy precertification list (Fylnetra) Empire BlueCross expands specialty pharmacy precertification list (Spevigo, Xenpozyme) Specialty pharmacy precertification list expansion (Rolvedon, Stimufend) New specialty pharmacy medical step therapy requirements (Infed, Injectafer, Monoferric) AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Prior authorization requirement changes effective April 1, 2023 Medical Policies and Clinical Utilization Management Guidelines update Revised program implementation date prior authorizations for post-acute care Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023	February 2023 Newsletter	Medicare	Feb 1, 2023
Important reminder: New ID cards for many of our Empire BlueCross BlueShield members	New ID cards for Empire BlueCross BlueShield members	Administrative	Jan 19, 2023
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Professional system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Engagement with your patient counts	January 2023 Newsletter	Administrative	Dec 30, 2022
Childhood Immunization Status and Lead Screening in Children for HEDIS	January 2023 Newsletter	Administrative	Dec 30, 2022
Outpatient system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Remittance advice message enhancements: Providing clear descriptions and actionable next steps	January 2023 Newsletter	Administrative	Dec 30, 2022
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Outpatient facility revenue code billing requirements	January 2023 Newsletter	Administrative	Dec 30, 2022
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Monkeypox and smallpox vaccines: Product code on claims	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines* Material adverse change Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Medical Policy and Clinical Guidelines updates Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Notification regarding reimbursement changes to COVID-19 laboratory services codes Material Adverse Change (MAC)	January 2023 Newsletter	Reimbursement Policies	Dec 30, 2022
Specialty pharmacy updates Material Adverse Change (MAC)	January 2023 Newsletter	Pharmacy	Dec 30, 2022
Federal Employee Program observation conversion for musculoskeletal cases Material Adverse Change (MAC)	January 2023 Newsletter	Federal Employee Plan (FEP)	Dec 30, 2022
Use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services	January 2023 Newsletter	Medicaid	Dec 30, 2022
Keep up with Medicaid news - January 2023 View these Medicaid articles: This is Quitting: Helping teens and young adults quit vaping *Update to AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines* CPT code list** AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update	January 2023 Newsletter	Medicaid	Dec 30, 2022
Keep up with Medicare news - January 2023 View these Medicare articles: Prior authorization requirement changes New specialty pharmacy medical step therapy requirements Empire BlueCross BlueShield expands specialty pharmacy precertification list	January 2023 Newsletter	Medicare	Dec 30, 2022
Attention lab providers: COVID-19 update regarding reimbursement Material Adverse Change (MAC)	December 2022 Newsletter	Administrative	Dec 1, 2022
Important information about utilization management	December 2022 Newsletter	Administrative	Dec 1, 2022
State of Connecticut employer group - BlueCare Prime update	December 2022 Newsletter	Administrative	Dec 1, 2022
IngenioRx will become CarelonRx on January 1, 2023	December 2022 Newsletter	Administrative	Dec 1, 2022
CAA: Timely updates help keep our provider directories current	December 2022 Newsletter	Administrative	Dec 1, 2022
Member assessment of PCP after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Clinical practice and preventive health guidelines available on empireblue.com	December 2022 Newsletter	Administrative	Dec 1, 2022
Signature requirements for laboratory orders or requisitions	December 2022 Newsletter	Administrative	Dec 1, 2022
Case management program	December 2022 Newsletter	Administrative	Dec 1, 2022
Coordination of care	December 2022 Newsletter	Administrative	Dec 1, 2022
Member’s assessment of behavioral healthcare after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Members’ rights and responsibilities	December 2022 Newsletter	Administrative	Dec 1, 2022
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Pharmacy information available on the provider website	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Specialty pharmacy updates - December 2022 Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
Reimbursement policy update: Bundled Services and Supplies - Professional Material Adverse Change (MAC)	December 2022 Newsletter	Reimbursement Policies	Dec 1, 2022

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