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Provider Communications

Articles Category: State & Federal

Title Publication Category Date

2019 FEP Benefit information available online

December 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

2019 Medicare Advantage individual benefits and formularies

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Access patient-specific drug benefit information through electronic medical records

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Empire Provider News Medicaid Aug 1, 2019

Aspire Telehealth Palliative Care program

October 2019 Empire Provider News Medicare Oct 1, 2019

Attention: updated physician lab fee schedules for Medicare Advantage products

October 2019 Empire Provider News Medicare Oct 1, 2019

Behavioral health Discharge Action Plan: improving care transitions

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Behavioral health network provider training

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Benefit change for Infliximab for Federal Employee Program

December 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

December 2019 Empire Provider News Medicare Dec 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Empire Provider News Medicare Nov 1, 2019

Cervical length measurement by transvaginal ultrasound

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Changes to PA requirements

September 2019 Empire Provider News Medicare Sep 1, 2019

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

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

City of Cincinnati Retirement System to offer Medicare Advantage option

December 2019 Empire Provider News Medicare Dec 1, 2019

Clinical Criteria updates

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Clinical Criteria updates

May 2019 Empire Provider Newsletter Medicaid May 1, 2019

Clinical Criteria updates

September 2019 Empire Provider News Medicaid Sep 1, 2019

Clinical criteria updates for specialty pharmacy

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

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

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Empire Provider News Medicare Nov 1, 2019

Coding Spotlight - Obesity

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

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

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Coding Spotlight: Hypertension, A providers’ guide for coding

July 2019 Empire Provider News Medicaid Jul 1, 2019

Coding Spotlight: Pregnancy, A provider’s guide to diagnose and code for pregnancy

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Coding spotlight: substance use disorders and smoking

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Cologuard covered for Medicare Advantage

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Coming soon: electronic attachments

September 2019 Empire Provider News Medicaid Sep 1, 2019

Coming soon: electronic attachments

September 2019 Empire Provider News Medicare Sep 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Complex Case Management program

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Complex Case Management program

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Connecticut Teachers’ Retirement Board Offers Medicare Advantage Option

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Coordination of Benefits for an FEP member

December 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Coordination of Benefits for an FEP® member

December 2019 Empire Provider News Federal Employee Plan (FEP) Dec 1, 2019

Correction: Cervical length measurement by transvaginal ultrasound

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Empire Provider News Medicare Sep 1, 2019

Diabetes Coding

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

DME providers and physicians: important wheelchair prior authorization information

August 2018 Empire Provider Newsletter Medicare Aug 1, 2018

Dual Eligible Special Needs Plans - provider training required

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

East End Health Plan offers Medicare Advantage option

December 2019 Empire Provider News Medicare Dec 1, 2019

EDI Gateway migration

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

Electrical stimulation device to require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Electronic claim payment reconsideration

July 2019 Empire Provider News Medicaid Jul 1, 2019

Electronic data interchange gateway 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

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Empire Provider News Medicaid Nov 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Empire Provider News Medicare Nov 1, 2019

Empire eye refraction and routine eye exam billing information

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

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

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

October 2018 Empire Provider Newsletter Medicaid Oct 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Empire offers risk adjustment and documentation training

January 2019 Empire Provider Newsletter Medicare Jan 1, 2019

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

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Empire transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

October 2018 Empire Provider Newsletter Medicare Oct 1, 2018

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

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

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review

October 2019 Empire Provider News Federal Employee Plan (FEP) Oct 1, 2019

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

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

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

July 2019 Empire Provider News Medicaid Jul 1, 2019

HEDIS 2019 Federal Employee Program medical record request requirements

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

Help prevent preeclampsia with prenatal aspirin

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Home health billing guidelines for contracted providers

July 2019 Empire Provider News Medicare Jul 1, 2019

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

Important information about utilization management

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Intervention for blood sugar control in pregnant women with diabetes

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

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

March 2019 Empire Provider Newsletter Medicare Mar 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

Keep up with Medicaid news

November 2019 Empire Provider News Medicaid Nov 1, 2019

Keep up with Medicaid news

October 2019 Empire Provider News Medicaid Oct 1, 2019

Keep up with Medicaid news

August 2019 Empire Provider News Medicaid Aug 1, 2019

Keep up with Medicare news

August 2019 Empire Provider News Medicare Aug 1, 2019

Keep up with Medicare news

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Keep up with Medicare news

August 2018 Empire Provider Newsletter Medicare Aug 1, 2018

Keep up with Medicare news

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Keep up with Medicare news

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Keep up with Medicare News

December 2019 Empire Provider News Medicare Dec 1, 2019

Keep up with Medicare news

June 2019 Empire Provider Newsletter Medicare Jun 1, 2019

Keep up with Medicare news

July 2019 Empire Provider News Medicare Jul 1, 2019

Keep up with Medicare news

January 2019 Empire Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

November 2019 Empire Provider News Medicare Nov 1, 2019

Keep up with Medicare news

October 2019 Empire Provider News Medicare Oct 1, 2019

Keep up with Medicare news

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Keep up with Medicare news

October 2018 Empire Provider Newsletter Medicare Oct 1, 2018

Keep up with Medicare news

May 2019 Empire Provider Newsletter Medicare May 1, 2019

Keep up with Medicare news

September 2019 Empire Provider News Medicare Sep 1, 2019

Lower extremity vascular intervention codes require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Lowering health risks with no-cost statins

October 2019 Empire Provider News Medicare Oct 1, 2019

MA home health network to be delegated to myNEXUS

June 2018 Empire Provider Newsletter Medicare May 30, 2018

MA members receive incentives for completing screenings

August 2018 Empire Provider Newsletter Medicare Aug 1, 2018

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.

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

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

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

MCG Care Guidelines update and customizations

September 2019 Empire Provider News Medicaid Sep 1, 2019
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