New York
Provider Communications

Articles Category: State & Federal / Medicaid

Title	Publication	Category	Date
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
Electronic Data Interchange migration to Availity	August 2018 Empire Provider Newsletter	Medicaid	Aug 1, 2018
New pregnancy notification process using the Availity Portal Benefit Look-Up tool	August 2018 Empire Provider Newsletter	Medicaid	Aug 1, 2018
Normal newborn diagnosis-related group claims processing update	August 2018 Empire Provider Newsletter	Medicaid	Aug 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
EDI Gateway migration	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
Empire Fights opioid addiction: Extension for Community Health Care Outcomes and Quality Medication-Assisted Therapy	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
Vaginal birth after cesarean shared decision-making aid available	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
Cervical length measurement by transvaginal ultrasound	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
Prior authorization requirements for high-level, definitive drug testing	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
Prior authorization requirements for Interferon beta-1a	October 2018 Empire Provider Newsletter	Medicaid	Oct 1, 2018
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
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
Coding spotlight: substance use disorders and smoking	December 2018 Empire Provider Newsletter	Medicaid	Dec 1, 2018
Pharmacy management information	December 2018 Empire Provider Newsletter	Medicaid	Dec 1, 2018
Practitioners’ rights during credentialing process	December 2018 Empire Provider Newsletter	Medicaid	Dec 1, 2018
Transition of Outpatient Rehabilitation Utilization Management program	January 2019 Empire Provider Newsletter	Medicaid	Jan 1, 2019
My Diverse Patients: A website to support your diverse patients	January 2019 Empire Provider Newsletter	Medicaid	Jan 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
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
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
Correction: Cervical length measurement by transvaginal ultrasound	April 2019 Empire Provider Newsletter	Medicaid	Apr 1, 2019
Medical necessity review for appropriate level of care	April 2019 Empire Provider Newsletter	Medicaid	Apr 1, 2019
Online registration processes for electronic funds transfers and electronic remittance advices	April 2019 Empire Provider Newsletter	Medicaid	Apr 1, 2019
Medical Policies and Clinical Utilization Management Guidelines update	April 2019 Empire Provider Newsletter	Medicaid	Apr 1, 2019
Provider surveys	April 2019 Empire Provider Newsletter	Medicaid	Apr 1, 2019
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 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
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
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
Electronic claim payment reconsideration	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
AIM Specialty Health programs may require documentation	August 2019 Empire Provider News	Medicaid	Aug 1, 2019
Pharmacy management information	August 2019 Empire Provider News	Medicaid	Aug 1, 2019
Use the Provider Maintenance Form to update your information	August 2019 Empire Provider News	Medicaid	Aug 1, 2019
Prepayment clinical validation review process	August 2019 Empire Provider News	Medicaid	Aug 1, 2019
Keep up with Medicaid news	August 2019 Empire Provider News	Medicaid	Aug 1, 2019
Coming soon: electronic attachments	September 2019 Empire Provider News	Medicaid	Sep 1, 2019
Prior authorization changes	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
Clinical Criteria updates	September 2019 Empire Provider News	Medicaid	Sep 1, 2019
MCG Care Guidelines update and customizations	September 2019 Empire Provider News	Medicaid	Sep 1, 2019
Ensuring quality of care when prescribing antipsychotic medications to children and adolescents	September 2019 Empire Provider News	Medicaid	Sep 1, 2019

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