New York
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

Update to corrected claims filing guidelines

April 2020 Empire Provider News Medicaid Apr 1, 2020

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

Verifying and updating your provider information

January 2020 Empire Provider News Medicaid Jan 1, 2020

UPDATE: Prior authorization requirements for high-level, definitive drug testing delayed

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Improving the patient experience

January 2020 Empire Provider News Medicaid Jan 1, 2020

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

Medical drug benefit Clinical Criteria updates - August 2019

January 2020 Empire Provider News Medicaid Jan 1, 2020

Reimbursement Policy Update: Claims Requiring Additional Documentation (Policy 06-031, effective 03/01/19)

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Medical drug benefit Clinical Criteria - September 2019

January 2020 Empire Provider News Medicaid Jan 1, 2020

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

January 2020 Empire Provider News Medicaid Jan 1, 2020

Medical Policies and Clinical Utilization Management Guidelines update

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Coding spotlight - provider’s guide to coding respiratory diseases

January 2020 Empire Provider News Medicaid Jan 1, 2020

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

What Matters Most online training course: improving patient experience

September 2020 Empire Provider News Medicaid Sep 1, 2020

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

Medical drug benefit Clinical Criteria updates

September 2020 Empire Provider News Medicaid Sep 1, 2020

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

Medical Policies and Clinical Utilization Management Guidelines update

September 2020 Empire Provider News Medicaid Sep 1, 2020

Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Keep up with Medicaid news

September 2020 Empire Provider News Medicaid Sep 1, 2020

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

Controlling High Blood Pressure (CBP)

August 2020 Empire Provider News Medicaid Aug 1, 2020

New HEDIS/QARR measures for 2018

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Medical drug benefit Clinical Criteria updates

August 2020 Empire Provider News Medicaid Aug 1, 2020

Provider data update

August 2020 Empire Provider News Medicaid Aug 1, 2020

Home- and community-based services for Health and Recovery Plan beneficiaries

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

August 2020 Empire Provider News Medicaid Aug 1, 2020

Keep up with Medicaid news

April 2021 Newsletter Medicaid Apr 1, 2021

Important information about utilization management

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) (Effective 05/01/20)

February 2020 Empire Provider News Medicaid Feb 1, 2020

Keep up with Medicaid news

August 2020 Empire Provider News Medicaid Aug 1, 2020

Member’s Rights and Responsibilities Statement

August 2018 Empire Provider Newsletter Medicaid Aug 1, 2018

Resources to support your diverse patient panel

February 2020 Empire Provider News Medicaid Feb 1, 2020

Non-covered codes for Medicaid Managed Care (MMC) providers

February 2020 Empire Provider News Medicaid Feb 1, 2020

Keep up with Medicaid news

February 2020 Empire Provider News Medicaid Feb 1, 2020

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

Provider education program survey: Your Voice Counts

June 2021 Newsletter Medicaid Jun 1, 2021

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

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicaid Jun 1, 2021

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

Keeping up with routine vaccination during COVID-19

June 2021 Newsletter Medicaid Jun 1, 2021

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

Aspire Health for members in need of palliative care

June 2021 Newsletter Medicaid Jun 1, 2021

What Matters Most: Improving the Patient Experience

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Complex Case Management program

June 2021 Newsletter Medicaid Jun 1, 2021

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

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

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

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

Update: evaluation and management with Modifier 25

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Keep up with Medicaid news

July 2021 Newsletter Medicaid Jul 1, 2021

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

Access to more claim denial information is now self-service

March 2021 Empire Provider News Medicaid Mar 1, 2021

MCG Care Guidelines 24th edition customization

March 2021 Empire Provider News Medicaid Mar 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

March 2021 Empire Provider News Medicaid Mar 1, 2021

Ocrevus/Vyepti Medical Step Therapy Notice

March 2021 Empire Provider News Medicaid Mar 1, 2021

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Empire Provider News Medicaid Jun 1, 2020

2020 affirmative statement concerning utilization management decisions

June 2020 Empire Provider News Medicaid Jun 1, 2020

Modifier use reminders

June 2020 Empire Provider News Medicaid Jun 1, 2020

Coding spotlight - provider’s guide to code social determinants of health

June 2020 Empire Provider News Medicaid Jun 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Empire Provider News Medicaid Jun 1, 2020

Complex Case Management program

June 2020 Empire Provider News Medicaid Jun 1, 2020

Members’ Rights and Responsibilities Statement

June 2020 Empire Provider News Medicaid Jun 1, 2020

Important information about utilization management

June 2020 Empire Provider News Medicaid Jun 1, 2020

Keep up with Medicaid news

June 2020 Empire Provider News Medicaid Jun 1, 2020

Medical drug benefit Clinical Criteria updates

July 2020 Empire Provider News Medicaid Jul 1, 2020

Introducing Interactive Care Reviewer - An online prior authorization tool

July 2020 Empire Provider News Medicaid Jul 1, 2020
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