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Provider Communications

Articles Category: State & Federal

Title Publication Category Date

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

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

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

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

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

Making a change for the better - FEP system migration information.

July 2018 Empire Network eUpdate Federal Employee Plan (FEP) Jul 2, 2018

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
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