New York
Provider Communications

Articles Month: December 2018

Title	Publication	Category	Date
When and how to initiate Medicare Advantage reopenings	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
MediBlue Select HMO Network expands effective January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Medical Policies updated	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
Keep up with Medicare news	December 2018 Empire Provider Newsletter	Medicare	Dec 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
Clinical Guideline Updates	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Empire accepts electronic prior authorization requests for prescription medications online	December 2018 Empire Provider Newsletter	Pharmacy	Dec 1, 2018
Introducing the new Clinical Criteria page for injectable, infused or implanted drugs	December 2018 Empire Provider Newsletter	Pharmacy	Dec 1, 2018
Pharmacy information available on empireblue.com	December 2018 Empire Provider Newsletter	Pharmacy	Dec 1, 2018
Empire announces a new network - Blue Access	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Empire announces changes to the Individual Health Benefit Plans	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Prepare NOW for Empire Facility and Physician Portal Retirement	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Availity to serve as EDI entry point for electronic submissions	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Explore new enhancements to the Education and Reference Center	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Company works to simplify payment recovery process for National Accounts membership	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
HEDIS® 2018 Commercial Results Are In	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Case Management Program	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
ConditionCare Program Benefits Patients and Physicians	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physicians	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Coordination of Care	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Important Information about Utilization Management	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Members’ Rights and Responsibilities	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Clinical practice and preventive health guidelines available online	December 2018 Empire Provider Newsletter	Administrative	Dec 1, 2018
Policy updates	December 2018 Empire Provider Newsletter	Policy Updates	Dec 1, 2018
Medical Policy Updates	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Review medical policy and clinical guidelines when referring services to a facility	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Update to AIM Clinical Appropriateness Guidelines	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines	December 2018 Empire Provider Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2018
Reimbursement Policy Updates	December 2018 Empire Provider Newsletter	Reimbursement Policies	Dec 1, 2018
Reimbursement for Convenience Surgical Supply Kits - Professional	December 2018 Empire Provider Newsletter	Reimbursement Policies	Dec 1, 2018
Bundled Services and Supplies - Professional	December 2018 Empire Provider Newsletter	Reimbursement Policies	Dec 1, 2018
Reimbursement Policy Update - Scope of License (Professional)	December 2018 Empire Provider Newsletter	Reimbursement Policies	Dec 1, 2018
Coordination of Benefits for an FEP member	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
Benefit change for Infliximab for Federal Employee Program	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
2019 FEP Benefit information available online	December 2018 Empire Provider Newsletter	Federal Employee Plan (FEP)	Dec 1, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
2019 Medicare Advantage individual benefits and formularies	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018
CMS Medicare Preclusion List effective April 1, 2019	December 2018 Empire Provider Newsletter	Medicare	Dec 1, 2018

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