New York
Provider Communications

April 2020 Empire Provider News

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Title Category

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin July 1, 2020

Products & Programs

Empire prior authorization updates for specialty pharmacy are available

Pharmacy

Empire to delay most 4/1/2020 formulary list updates for commercial health plan pharmacy benefit

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

Information from Empire for Care Providers about COVID-19

Administrative

Anthem, Inc., Empire’s parent company, acquires Beacon Health Options

Administrative

Provider Transparency Update

Administrative

Empire continues focus on updates to our public provider website

Administrative

MCG Care Guidelines 24th Edition

Administrative

Policy Updates

Medical Policy & Clinical Guidelines

HEDIS 2020 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

Prior authorization requirements: new 2020 codes for coverage and precertification

Medicaid

Medical drug benefit Clinical Criteria updates (November 2019)

Medicaid

Medical drug benefit Clinical Criteria updates (December 2019)

Medicaid

Update to corrected claims filing guidelines

Medicaid

Use of Imaging Studies for Low Back Pain (LBP)

Medicaid

Disease Management can help you care for patients with chronic health care needs

Medicaid

Appointment access standards for PCPs, specialty care and behavioral health practitioners

Medicaid

Keep up with Medicaid news

Medicaid

Medical drug benefit Clinical Criteria updates (November 2019)

Medicare

Medical drug benefit Clinical Criteria updates (December 2019)

Medicare

2020 Medicare risk adjustment provider trainings

Medicare

Keep up with Medicare news

Medicare
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