New York
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

2022 FEP® Benefit information available online

January 2022 Newsletter Federal Employee Plan (FEP) Jan 1, 2022

Botox update for Empire BlueCross BlueShield HealthPlus members

January 2022 Newsletter Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Newsletter Medicaid Jan 1, 2022

2021 CAHPS Survey results

January 2022 Newsletter Medicaid Jan 1, 2022

Keep up with Medicaid news - January 2022

View these Medicaid articles:

  • AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
    update
  • Prior authorization updates for medications billed under the medical
    benefit
January 2022 Newsletter Medicaid Jan 1, 2022

NYC Medicare Advantage Plus effective date change

January 2022 Newsletter Medicare Jan 1, 2022

Important update on Botox® for Medicare members of Empire BlueCross BlueShield

January 2022 Newsletter Medicare Jan 1, 2022

Local 282 Welfare Trust Fund moves to Empire MediBlue Freedom (PPO) Medical plan

January 2022 Newsletter Medicare Jan 1, 2022

Professional claims — billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

January 2022 Newsletter Medicare Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Newsletter Medicare Jan 1, 2022

Keep up with Medicare news - January 2022

View these Medicare articles:

  • Medical step therapy updates
  • Empire BlueCross expands specialty pharmacy precertification list
  • AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
    update
January 2022 Newsletter Medicare Jan 1, 2022

Reimbursement policy update: Drug Screen Testing (effective March 1, 2022)

December 2021 Newsletter Medicaid Dec 1, 2021

Reimbursement policy update: Multiple and Bilateral Surgery - Professional and Facility (effective 03/01/22)

December 2021 Newsletter Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Drug Dependency

December 2021 Newsletter Medicaid Dec 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

December 2021 Newsletter Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

December 2021 Newsletter Medicaid Dec 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

December 2021 Newsletter Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Newsletter Medicaid Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Newsletter Medicaid Dec 1, 2021

Keep up with Medicaid news - December 2021

View these Medicaid articles:

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Cancer Care Navigator
  • Medical drug benefit Clinical Criteria updates
  • Prior authorization updates for medications billed under the medical
    benefit
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
December 2021 Newsletter Medicaid Dec 1, 2021

City of New York GRS Alliance Program (Updated 12/3/21)

December 2021 Newsletter Medicare Dec 1, 2021

Webinars for City of New York retirees transitioning to new Medicare Advantage plan (Updated 12/3/21)

December 2021 Newsletter Medicare Dec 1, 2021

Reimbursement Policy Update: Drug Screen Testing (effective March 1, 2022)

December 2021 Newsletter Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

December 2021 Newsletter Medicare Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Newsletter Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Newsletter Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Newsletter Medicare Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Newsletter Medicare Dec 1, 2021

Keep up with Medicare news - December 2021

View these Medicare articles:

  • Medical drug benefit Clinical Criteria updates
  • FAQ: NYC Medicare Advantage Plus
  • Protocol for providers serving members with hearing aid
    coverage administered by Hearing Care Solutions
  • Medical Policies and Clinical Utilization Management Guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
December 2021 Newsletter Medicare Dec 1, 2021

New York state Medicaid expansion of coverage for colorectal cancer screening

November 2021 Newsletter Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Newsletter Medicaid Nov 1, 2021

Clinical Criteria updates

November 2021 Newsletter Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Newsletter Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your women patients

November 2021 Newsletter Medicaid Nov 1, 2021

Keep up with Medicaid news - November 2021

View these Medicaid articles:
  • Medicaid continuous glucose monitoring systems
  • Prior authorization updates for specialty pharmacy
November 2021 Newsletter Medicaid Nov 1, 2021

Webinars for City of New York retirees transitioning to new Medicare Advantage plan

November 2021 Newsletter Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Newsletter Medicare Nov 1, 2021

Clinical Criteria updates

November 2021 Newsletter Medicare Nov 1, 2021

Empire BlueCross BlueShield offering Advance Medical Directives program for 2022

November 2021 Newsletter Medicare Nov 1, 2021

Keep up with Medicare news - November 2021

View this Medicare article:

  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
November 2021 Newsletter Medicare Nov 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Newsletter Medicaid Oct 1, 2021

Diabetes testing and screening HEDIS measures

October 2021 Newsletter Medicaid Oct 1, 2021

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

October 2021 Newsletter Medicaid Oct 1, 2021

FAQ: Update to AIM phone number

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy IV

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy V

October 2021 Newsletter Medicaid Oct 1, 2021

Keep up with Medicaid news - October 2021

View these Medicaid articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Newsletter Medicaid Oct 1, 2021

Webinars for City of New York retirees transitioning to new Medicare Advantage plan

October 2021 Newsletter Medicare Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Newsletter Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Newsletter Medicare Oct 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

October 2021 Newsletter Medicare Oct 1, 2021

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

October 2021 Newsletter Medicare Oct 1, 2021

New Medical Step Therapy Requirements

October 2021 Newsletter Medicare Oct 1, 2021

Keep up with Medicare news - October 2021

View these Medicare articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Newsletter Medicare Oct 1, 2021

Federal Employee Program® AIM Radiology prior authorization review transition delayed until November

Material adverse change (MAC) notification

September 2021 Newsletter Federal Employee Plan (FEP) Sep 1, 2021

Keep up with Medicaid news - September 2021

View these Medicaid article: 
  • Clinical Criteria Updates Notification May 2021
  • Iron Infusion Step Therapy
  • Iron Infusion Prior Authorization Update
September 2021 Newsletter Medicaid Sep 1, 2021

City of New York Offers NYC Medicare Advantage Plus Medicare Advantage Option

September 2021 Newsletter Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers (Effective 11/30/21)

September 2021 Newsletter Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Newsletter Medicare Sep 1, 2021

Prior authorization/Precertification form notification

September 2021 Newsletter Medicare Sep 1, 2021

Keep up with Medicare news - September 2021

View this Medicare article:

  • Clinical Criteria Updates Notification May 2021
September 2021 Newsletter Medicare Sep 1, 2021

Change in email submission of service requests for Federal Employee Program members

Material adverse change (MAC) notification
August 2021 Newsletter Federal Employee Plan (FEP) Aug 1, 2021

Keep up with Medicaid news

August 2021 Newsletter Medicaid Aug 1, 2021

City of New York offers Medicare Advantage option in 2022

August 2021 Newsletter Medicare Aug 1, 2021

Preventing claims denials: Shingles vaccine

August 2021 Newsletter Medicare Aug 1, 2021

Policy reminder: Inpatient Readmissions

August 2021 Newsletter Medicare Aug 1, 2021

Keep up with Medicare news

August 2021 Newsletter Medicare Aug 1, 2021

Federal Employee Program® AIM Radiology prior authorization review

Material adverse change (MAC) notification
July 2021 Newsletter Federal Employee Plan (FEP) Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients

July 2021 Newsletter Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Newsletter Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)

July 2021 Newsletter Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Newsletter Medicaid Jul 1, 2021

Certain specialty medication precertification requests may require additional documentation

July 2021 Newsletter Medicaid Jul 1, 2021

Medical drug benefit Clinical Criteria updates

July 2021 Newsletter Medicaid Jul 1, 2021

Retraction: AIM Rehabilitative program — initial evaluations and site of service reviews

July 2021 Newsletter Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal program clinical appropriateness guidelines

July 2021 Newsletter Medicaid Jul 1, 2021

Coding spotlight: mental disorders in childhood

July 2021 Newsletter Medicaid Jul 1, 2021

What Matters Most: Improving the Patient Experience

July 2021 Newsletter Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Newsletter Medicaid Jul 1, 2021

Keep up with Medicaid news

July 2021 Newsletter Medicaid Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients

July 2021 Newsletter Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Newsletter Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)

July 2021 Newsletter Medicare Jul 1, 2021

Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428

July 2021 Newsletter Medicare Jul 1, 2021

Medical drug benefit Clinical Criteria updates

July 2021 Newsletter Medicare Jul 1, 2021

DEXA bone scan criteria for the Federal Employee Program

June 2021 Newsletter Federal Employee Plan (FEP) Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Newsletter Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Newsletter Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Newsletter Medicaid Jun 1, 2021

Complex Case Management program

June 2021 Newsletter Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Newsletter Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Newsletter Medicaid Jun 1, 2021

Keep up with Medicaid news

June 2021 Newsletter Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicare Jun 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

June 2021 Newsletter Medicare Jun 1, 2021

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

June 2021 Newsletter Medicare Jun 1, 2021

Keep up with Medicare news

June 2021 Newsletter Medicare Jun 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Newsletter Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Newsletter Medicaid May 1, 2021
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