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Provider Communications

Articles Category: State & Federal

Title	Publication	Category	Date
Cologuard covered for Medicare Advantage	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
Peer-to-peer process can help clarify clinical record	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
Motion Picture Industry Pension and Health Plans Offers Medicare Advantage Option	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
Connecticut Teachers’ Retirement Board Offers Medicare Advantage Option	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
MA home health network to be delegated to myNEXUS	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
Medication adherence incentive offered to EPHC providers	June 2018 Empire Provider Newsletter	Medicare	May 30, 2018
Keep up with Medicare news	June 2018 Empire Provider Newsletter	Medicare	May 30, 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
Prior authorization requirements for Darzalex (daratumumab) drug	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Services requiring prior authorization	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Medical Policies and Clinical Utilization Management Guidelines update	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Behavioral health network provider training	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Behavioral health Discharge Action Plan: improving care transitions	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Provider surveys	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Use the Provider Maintenance Form to update your information	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Complex Case Management program	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
What Matters Most: Improving the Patient Experience	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Coding Spotlight: Pregnancy, A provider’s guide to diagnose and code for pregnancy	June 2018 Empire Provider Newsletter	Medicaid	May 30, 2018
Making a change for the better - FEP® system migration information	June 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	May 30, 2018
Making a change for the better - FEP system migration information.	July 2018 Empire Network eUpdate	Federal Employee Plan (FEP)	Jul 2, 2018
Making a change for the better - FEP system migration information	August 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Aug 1, 2018
MA members receive incentives for completing screenings	August 2018 Empire Provider Newsletter	Medicare	Aug 1, 2018
DME providers and physicians: important wheelchair prior authorization information	August 2018 Empire Provider Newsletter	Medicare	Aug 1, 2018
Submit PA medication requests electronically; new phone number for MA prescription PAs effective Sept. 1	August 2018 Empire Provider Newsletter	Medicare	Aug 1, 2018
CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective Jan. 1, 2019	August 2018 Empire Provider Newsletter	Medicare	Aug 1, 2018
MyDiversePatients.com addresses health care disparities	August 2018 Empire Provider Newsletter	Medicare	Aug 1, 2018
Keep up with Medicare news	August 2018 Empire Provider Newsletter	Medicare	Aug 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
Genetic testing prior authorization by ordering physician helps ensure accurate lab payment	October 2018 Empire Provider Newsletter	Medicare	Oct 1, 2018
Empire transitions MA back pain management and cardiology UM programs from OrthoNet to AIM	October 2018 Empire Provider Newsletter	Medicare	Oct 1, 2018
Please evaluate statin use for MA members with diabetes, cardiovascular disease	October 2018 Empire Provider Newsletter	Medicare	Oct 1, 2018
Medicare pharmacy and prescriber home starts January 2019	October 2018 Empire Provider Newsletter	Medicare	Oct 1, 2018
Group sponsored Medicare Advantage plan members to receive new ID cards	October 2018 Empire Provider Newsletter	Medicare	Oct 1, 2018
Keep up with Medicare news	October 2018 Empire Provider Newsletter	Medicare	Oct 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
When and how to initiate Medicare Advantage reopenings	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
MediBlue Select HMO Network expands effective January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Medical Policies updated	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Keep up with Medicare news	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
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
Coordination of Benefits for an FEP member	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
Benefit change for Infliximab for Federal Employee Program	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
2019 FEP Benefit information available online	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
2019 Medicare Advantage individual benefits and formularies	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
CMS Medicare Preclusion List effective April 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Empire offers risk adjustment and documentation training	January 2019 Empire Provider Newsletter	Medicare	Jan 1, 2019
Medicare Advantage member Explanation of Benefits redesigned	January 2019 Empire Provider Newsletter	Medicare	Jan 1, 2019
Keep up with Medicare news	January 2019 Empire Provider Newsletter	Medicare	Jan 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
HEDIS 2019 Federal Employee Program medical record request requirements	February 2019 Empire Provider Newsletter	Federal Employee Plan (FEP)	Feb 1, 2019
Reminder - Empire follows Original Medicare policies	February 2019 Empire Provider Newsletter	Medicare	Feb 1, 2019
Use grouped CPT codes for AIM Specialty Health authorizations	February 2019 Empire Provider Newsletter	Medicare	Feb 1, 2019
Empire eye refraction and routine eye exam billing information	February 2019 Empire Provider Newsletter	Medicare	Feb 1, 2019
New specialty Medicare Part B device preferred product program	February 2019 Empire Provider Newsletter	Medicare	Feb 1, 2019
Keep up with Medicare news	February 2019 Empire Provider Newsletter	Medicare	Feb 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

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