New York
Provider Communications

Articles Category: State & Federal > Medicaid

Title Publication Category Date

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Empire Provider News Medicaid Nov 1, 2019

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

November 2019 Empire Provider News Medicaid Nov 1, 2019

Keep up with Medicaid news

November 2019 Empire Provider News Medicaid Nov 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update - March 2019

October 2019 Empire Provider News Medicaid Oct 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update - June 2019

October 2019 Empire Provider News Medicaid Oct 1, 2019

New clinical guideline: pneumatic compression devices, effective December 1, 2019

October 2019 Empire Provider News Medicaid Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Empire Provider News Medicaid Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Empire Provider News Medicaid Oct 1, 2019

Keep up with Medicaid news

October 2019 Empire Provider News Medicaid Oct 1, 2019

Coming soon: electronic attachments

September 2019 Empire Provider News Medicaid Sep 1, 2019

Prior authorization changes

September 2019 Empire Provider News Medicaid Sep 1, 2019

Evaluation and management services - over-coded services

September 2019 Empire Provider News Medicaid Sep 1, 2019

Clinical Criteria updates

September 2019 Empire Provider News Medicaid Sep 1, 2019

MCG Care Guidelines update and customizations

September 2019 Empire Provider News Medicaid Sep 1, 2019

Ensuring quality of care when prescribing antipsychotic medications to children and adolescents

September 2019 Empire Provider News Medicaid Sep 1, 2019

Provider satisfaction survey

September 2019 Empire Provider News Medicaid Sep 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Empire Provider News Medicaid Aug 1, 2019

Pharmacy management information

August 2019 Empire Provider News Medicaid Aug 1, 2019

Use the Provider Maintenance Form to update your information

August 2019 Empire Provider News Medicaid Aug 1, 2019

Prepayment clinical validation review process

August 2019 Empire Provider News Medicaid Aug 1, 2019

Keep up with Medicaid news

August 2019 Empire Provider News Medicaid Aug 1, 2019

New service types added to Availity

July 2019 Empire Provider News Medicaid Jul 1, 2019

Trauma-informed care

July 2019 Empire Provider News Medicaid Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Empire Provider News Medicaid Jul 1, 2019

Unspecified diagnosis code update

July 2019 Empire Provider News Medicaid Jul 1, 2019

Coding Spotlight: Hypertension, A providers’ guide for coding

July 2019 Empire Provider News Medicaid Jul 1, 2019

Health Homes - a valuable provider of community-based care coordination

July 2019 Empire Provider News Medicaid Jul 1, 2019

Reimbursement Policy Update: Multiple Radiology Payment Reduction (Policy 12-002)

July 2019 Empire Provider News Medicaid Jul 1, 2019

Pharmacy benefit manager change

July 2019 Empire Provider News Medicaid Jul 1, 2019

New York City Department of Health advisory: HIV outbreak risk factors are present in New York City

July 2019 Empire Provider News Medicaid Jul 1, 2019

Electronic claim payment reconsideration

July 2019 Empire Provider News Medicaid Jul 1, 2019

Prior authorization requirement update

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Remittance Inquiry tool now available

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Intervention for blood sugar control in pregnant women with diabetes

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Complex Case Management program

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Important information about utilization management

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Members’ Rights and Responsibilities Statement

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Clinical Criteria updates

May 2019 Empire Provider Newsletter Medicaid May 1, 2019

Clinical Criteria updates

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Help prevent preeclampsia with prenatal aspirin

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Correction: Cervical length measurement by transvaginal ultrasound

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Medical necessity review for appropriate level of care

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Online registration processes for electronic funds transfers and electronic remittance advices

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Provider surveys

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Practitioners’ rights during credentialing process

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Update: evaluation and management with Modifier 25

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Reimbursement Policy Update

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Coding Spotlight: Cancer A provider’s guide to properly code cancers

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Access patient-specific drug benefit information through electronic medical records

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Neonatal intensive care unit post-traumatic stress disorder program

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

New specialty pharmacy medical step therapy requirements

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Diabetes Coding

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Transition of Outpatient Rehabilitation Utilization Management program

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

My Diverse Patients: A website to support your diverse patients

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

New Provider Learning Opportunity: Put the ProviderPortal to Work for You

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

Electronic data interchange gateway update

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Empire HealthPlus adopts MCG Care Guidelines for clinical reviews of mental health services

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Sublocade

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

UPDATE: Prior authorization requirements for high-level, definitive drug testing delayed

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Viral suppression rates improve in patients with HIV in the US,while disparities continue to exist

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Reimbursement Policy Update: Claims Requiring Additional Documentation (Policy 06-031, effective 03/01/19)

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Coding spotlight: substance use disorders and smoking

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Pharmacy management information

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Practitioners’ rights during credentialing process

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

EDI Gateway migration

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Empire Fights opioid addiction: Extension for Community Health Care Outcomes and Quality Medication-Assisted Therapy

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Vaginal birth after cesarean shared decision-making aid available

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Cervical length measurement by transvaginal ultrasound

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Prior authorization requirements for high-level, definitive drug testing

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Prior authorization requirements for Interferon beta-1a

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Prior authorization requirements for Somatrem

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update: effective 1/25/18

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update: effective 3/22/18

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update: effective 11/1/18

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Electronic Data Interchange migration to Availity

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

New pregnancy notification process using the Availity Portal Benefit Look-Up tool

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Normal newborn diagnosis-related group claims processing update

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Prior authorization requirements for Cabazitaxel (Jevtana)

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Coding Spotlight - Obesity

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Reimbursement Policy Update: Medical Recalls

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

New HEDIS/QARR measures for 2018

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Home- and community-based services for Health and Recovery Plan beneficiaries

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Important information about utilization management

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Member’s Rights and Responsibilities Statement

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Empire to conduct post-payment reviews of distinct procedural services modifiers

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Miscellaneous durable medical equipment billing guidelines

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Prior authorization requirement update for Mylotarg (gemtuzumab ozogamicin)

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Electrical stimulation device to require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Chimeric antigen receptor T-cell therapy requires prior authorization for all places of service

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Lower extremity vascular intervention codes require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018
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