New York
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Making a change for the better - FEP system migration information

August 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Aug 1, 2018

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

June 2018 Empire Provider Newsletter Federal Employee Plan (FEP) May 30, 2018

Empire Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

July 2019 Empire Provider News Federal Employee Plan (FEP) Jul 1, 2019

HEDIS 2019 Federal Employee Program medical record request requirements

February 2019 Empire Provider Newsletter Federal Employee Plan (FEP) Feb 1, 2019

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

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

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

Electronic Data Interchange migration to Availity

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Coding spotlight: substance use disorders and smoking

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Pharmacy management information

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Normal newborn diagnosis-related group claims processing update

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Practitioners’ rights during credentialing process

December 2018 Empire Provider Newsletter Medicaid Dec 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

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

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 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

Transition of Outpatient Rehabilitation Utilization Management program

January 2019 Empire Provider Newsletter Medicaid Jan 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

My Diverse Patients: A website to support your diverse patients

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

Electronic claim payment reconsideration

July 2019 Empire Provider News Medicaid Jul 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

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

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

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Help prevent preeclampsia with prenatal aspirin

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

EDI Gateway migration

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Correction: Cervical length measurement by transvaginal ultrasound

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

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

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Medical necessity review for appropriate level of care

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Vaginal birth after cesarean shared decision-making aid available

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Online registration processes for electronic funds transfers and electronic remittance advices

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Cervical length measurement by transvaginal ultrasound

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Prior authorization requirements for high-level, definitive drug testing

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Provider surveys

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Prior authorization requirements for Interferon beta-1a

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Practitioners’ rights during credentialing process

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Clinical Criteria updates

May 2019 Empire Provider Newsletter Medicaid May 1, 2019

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
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