New York
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Update to the Pregnancy Notification Form

December 2022 Newsletter Medicaid Dec 1, 2022

Oral health equity

December 2022 Newsletter Medicaid Dec 1, 2022

Keep up with Medicaid news - December 2022

View these Medicaid articles:
December 2022 Newsletter Medicaid Dec 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

December 2022 Newsletter Medicare Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Newsletter Medicare Dec 1, 2022

Personal home helper benefit ending

December 2022 Newsletter Medicare Dec 1, 2022

Keep up with Medicare news - December 2022

View these Medicaid articles:
December 2022 Newsletter Medicare Dec 1, 2022

Guidance for coding evaluation and management services for new and established patients

November 2022 Newsletter Medicaid Nov 1, 2022

Important information about utilization management

November 2022 Newsletter Medicaid Nov 1, 2022

Antipsychotic medications and diabetes

November 2022 Newsletter Medicaid Nov 1, 2022

Alcohol use disorders often coexist with psychiatric disorders

November 2022 Newsletter Medicaid Nov 1, 2022

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

November 2022 Newsletter Medicaid Nov 1, 2022

Keep up with Medicaid news - November 2022

View these Medicaid articles:
  • Medical drug benefit Clinical Criteria updates
  • Prior authorization requirement changes effective November 1, 2022
November 2022 Newsletter Medicaid Nov 1, 2022

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

November 2022 Newsletter Medicare Nov 1, 2022

Keep up with Medicare news - November 2022

View these Medicare articles:
  • Medical drug benefit Clinical Criteria updates
  • New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
  • New specialty pharmacy medical step therapy requirements (Zarxio)
November 2022 Newsletter Medicare Nov 1, 2022

Availity Provider Chat - a fast, easy way to get your UM questions answered for Federal Employees

October 2022 Newsletter Federal Employee Plan (FEP) Oct 1, 2022

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

October 2022 Newsletter Medicaid Oct 1, 2022

Monkeypox resources and recommendations for our care providers

October 2022 Newsletter Medicaid Oct 1, 2022

Members’ Rights and Responsibilities

October 2022 Newsletter Medicaid Oct 1, 2022

Complex Case Management program

October 2022 Newsletter Medicaid Oct 1, 2022

Flu vaccination reimbursement

October 2022 Newsletter Medicaid Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing (Professional)

October 2022 Newsletter Medicaid Oct 1, 2022

Keep up with Medicaid news - October 2022

View these Medicaid articles:
  • Prior authorization updates for medications billed under the medical benefit – effective 11/1/22
  • Prior authorization updates for medications billed under the medical benefit – effective 12/1/22
  • New specialty pharmacy medical step therapy requirements
October 2022 Newsletter Medicaid Oct 1, 2022

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

October 2022 Newsletter Medicare Oct 1, 2022

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

October 2022 Newsletter Medicare Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

October 2022 Newsletter Medicare Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing (Professional)

October 2022 Newsletter Medicare Oct 1, 2022

Keep up with Medicare news - October 2022

View these Medicare articles:
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list 
  • Consultation codes
October 2022 Newsletter Medicare Oct 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Newsletter Federal Employee Plan (FEP) Sep 1, 2022

Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003), (Informational only)

September 2022 Newsletter Medicaid Sep 1, 2022

Clinical Criteria updates

September 2022 Newsletter Medicaid Sep 1, 2022

New specialty pharmacy medical step therapy requirements

September 2022 Newsletter Medicaid Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Newsletter Medicaid Sep 1, 2022

Alcohol use disorders linked to chronic diseases

September 2022 Newsletter Medicaid Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Newsletter Medicare Sep 1, 2022

Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003)

September 2022 Newsletter Medicare Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Newsletter Medicare Sep 1, 2022

Empire BlueCross BlueShield expands specialty pharmacy precertification list – effective 11/1/2022

September 2022 Newsletter Medicare Sep 1, 2022

Empire BlueCross BlueShield expands specialty pharmacy precertification list - effective 12/1/2022

September 2022 Newsletter Medicare Sep 1, 2022

Reminder: AIM prior authorization phone number change for Medicare

September 2022 Newsletter Medicare Sep 1, 2022

Keep up with Medicare news - September 2022

View this Medicare article:
  • Clinical Criteria Updates
  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
September 2022 Newsletter Medicare Sep 1, 2022

HEDIS 2022: Summary of changes from NCQA

August 2022 Newsletter Medicaid Aug 1, 2022

Chlamydia screening

August 2022 Newsletter Medicaid Aug 1, 2022

Using SBIRT to address opioid and substance use disorders

August 2022 Newsletter Medicaid Aug 1, 2022

The cost of alcohol use disorder

August 2022 Newsletter Medicaid Aug 1, 2022

Prior authorization requirement changes updated effective date November 1, 2022

August 2022 Newsletter Medicaid Aug 1, 2022

Prior authorizations for post-acute care

August 2022 Newsletter Medicare Aug 1, 2022

Empire expands specialty pharmacy precertification list

August 2022 Newsletter Medicare Aug 1, 2022

Radiology prior authorization review transitioning to AIM

July 2022 Newsletter Federal Employee Plan (FEP) Jul 1, 2022

Prior authorization requirement changes effective August 1, 2022

July 2022 Newsletter Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Newsletter Medicaid Jul 1, 2022

Update to electronic verification visit key points

July 2022 Newsletter Medicaid Jul 1, 2022

Provider reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Counseling program

July 2022 Newsletter Medicaid Jul 1, 2022

Keep up with Medicaid news- July 2022

View these Medicaid articles:

  • Three-point match verification for professional claims payment
  • Prior authorization updates for medications billed under the medical benefit
  • Updates for medication codes billed under the medical benefit
July 2022 Newsletter Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Newsletter Medicare Jul 1, 2022

Bedford Central School District, New York moves to the Empire BlueCross BlueShield Retiree Solutions Medicare Advantage Plan

July 2022 Newsletter Medicare Jul 1, 2022

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Newsletter Medicare Jul 1, 2022

Cancer Care Navigator

July 2022 Newsletter Medicare Jul 1, 2022

Keep up with Medicare news - July 2022

View this Medicare article:

  • New specialty pharmacy medical step therapy requirements
July 2022 Newsletter Medicare Jul 1, 2022

Process change for Federal Employee Program® third-party correspondence requests

June 2022 Newsletter Federal Employee Plan (FEP) Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Newsletter Medicaid Jun 1, 2022

InterQual migration

June 2022 Newsletter Medicaid Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Newsletter Medicaid Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Newsletter Medicaid Jun 1, 2022

Keep up with Medicaid news- June 2022

View these Medicaid articles:

  • Prior authorization update for select durable medical equipment (DME) items
  • Prior authorization updates for medications billed under the medical benefit
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • Medical drug benefit Clinical Criteria updates
June 2022 Newsletter Medicaid Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Newsletter Medicare Jun 1, 2022

Medical drug benefit Clinical Criteria updates

June 2022 Newsletter Medicare Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Newsletter Medicare Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Newsletter Medicare Jun 1, 2022

Keep up with Medicare news - June 2022

View these Medicare articles:

  • New specialty pharmacy medical step therapy requirements
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
June 2022 Newsletter Medicare Jun 1, 2022

Join us for an FEP Quality Learning program live webinar

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP® Quality Reimbursement Program for PPO providers

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

Federal Employee Program® AIM radiology prior authorization review reminder

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Newsletter Medicaid May 1, 2022

New Strategic Provider System implementation May 2022

May 2022 Newsletter Medicaid May 1, 2022

CPT Category II update

May 2022 Newsletter Medicaid May 1, 2022

Keep up with Medicaid news- May 2022

View these Medicaid articles:

  • Prior authorization requirement changes for HCPCS code K1022
  • New specialty pharmacy medical step therapy requirements
May 2022 Newsletter Medicaid May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Newsletter Medicare May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Newsletter Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements

May 2022 Newsletter Medicare May 1, 2022

Keep up with Medicare news - May 2022

View these Medicare articles:

  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • New specialty pharmacy medical step therapy requirements
May 2022 Newsletter Medicare May 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Newsletter Federal Employee Plan (FEP) Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Medicaid Apr 1, 2022

Syphilis, including congenital cases, on the rise in New York

April 2022 Newsletter Medicaid Apr 1, 2022

Reimbursement Policy Update: Inpatient Readmissions

April 2022 Newsletter Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Newsletter Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Newsletter Medicaid Apr 1, 2022

Keep up with Medicaid news – April 2022

View these Medicaid articles:

  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
  • Prior authorization updates for medications billed under the medical benefit
  • Medical drug benefit Clinical Criteria updates
  • Medical Policies and Clinical Utilization Management Guidelines update
April 2022 Newsletter Medicaid Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Newsletter Medicare Apr 1, 2022

Reimbursement Policy Update: Inpatient Readmissions

April 2022 Newsletter Medicare Apr 1, 2022

Clinical Criteria updates

April 2022 Newsletter Medicare Apr 1, 2022

Model of Care required training

April 2022 Newsletter Medicare Apr 1, 2022

The impact of listening

April 2022 Newsletter Medicare Apr 1, 2022

Keep up with Medicare news – April 2022

View these Medicare articles:

  • Medical Policies and Clinical Utilization Management Guidelines update
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
April 2022 Newsletter Medicare Apr 1, 2022

Change to the Federal Employee Program® Clinical Grievance and Appeal Address

March 2022 Newsletter Federal Employee Plan (FEP) Mar 1, 2022

HEDIS 2022 Federal Employee Program® medical record request requirements

March 2022 Newsletter Federal Employee Plan (FEP) Mar 1, 2022

Required: Cultural competence training

March 2022 Newsletter Medicaid Mar 1, 2022

It is CAHPS survey time!

March 2022 Newsletter Medicaid Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Newsletter Medicaid Mar 1, 2022
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