New York
Provider Communications

Articles Month: July 2021

Title	Publication	Category	Date
Blue Precision program to be retired at the end of the year	July 2021 Newsletter	Products & Programs	Jul 1, 2021
Update: Site of Care medical necessity reviews for long-acting colony-stimulating factors will not be implemented on August 1, 2021 Material adverse change (MAC) notification	July 2021 Newsletter	Products & Programs	Jul 1, 2021
AIM Rehabilitative program - initial evaluations and site of service reviews	July 2021 Newsletter	Products & Programs	Jul 1, 2021
Certain specialty medication precertification requests may require additional documentation	July 2021 Newsletter	Pharmacy	Jul 1, 2021
Clinical Criteria updates for specialty pharmacy Material adverse change (MAC) notification	July 2021 Newsletter	Pharmacy	Jul 1, 2021
Updates for specialty pharmacy are effective October 1, 2021 Material adverse change (MAC) notification	July 2021 Newsletter	Pharmacy	Jul 1, 2021
Designated specialty pharmacy network updates effective October 1, 2021 Material adverse change (MAC) notification	July 2021 Newsletter	Pharmacy	Jul 1, 2021
Surgical Clinical Site of Care review updates	July 2021 Newsletter	Administrative	Jul 1, 2021
Proper coding for in-home monitoring can make a measurable difference for INR	July 2021 Newsletter	Administrative	Jul 1, 2021
Another mark of the pandemic: an increase in childhood obesity	July 2021 Newsletter	Administrative	Jul 1, 2021
Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims	July 2021 Newsletter	Administrative	Jul 1, 2021
Register now to learn strategies to help you and your practice improve clinical quality	July 2021 Newsletter	Administrative	Jul 1, 2021
Commercial Repapering: Important update	July 2021 Newsletter	Administrative	Jul 1, 2021
How to enroll in electronic fund transfer (EFT) for faster remittance	July 2021 Newsletter	Digital Tools	Jul 1, 2021
Electronic claim response files	July 2021 Newsletter	Digital Tools	Jul 1, 2021
Interactive Care Reviewer (ICR): New search option for cases submitted through ICR	July 2021 Newsletter	Digital Tools	Jul 1, 2021
Medical policy updates and clinical guideline updates Material adverse change (MAC) notification	July 2021 Newsletter	Medical Policy & Clinical Guidelines	Jul 1, 2021
New reimbursement policy: Non-patient Laboratory Services (Facility) Material adverse change (MAC) notification	July 2021 Newsletter	Reimbursement Policies	Jul 1, 2021
Reimbursement policy update: Consultations (Professional) Material adverse change (MAC) notification	July 2021 Newsletter	Reimbursement Policies	Jul 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
Register for upcoming August CME webinars Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings. Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations Tuesday, August 3, 2021, 12:00 p.m. ET 10 Best Practices for Improving Pharmacy Quality Measures Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET 6 Ways to Improve Risk Adjustment Documentation Accuracy Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET Register Now!	Clinical Quality CME Webinar Series Continues - New York	Administrative	Jul 28, 2021

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