New York
Provider Communications

May 2021 Newsletter

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Title Category

2021 affirmative statement regarding Utilization Management decisions

Administrative

A helpful and complete guide to covered well-child visits

Administrative

Appointment scheduler application

Administrative

Clinical criteria updates for specialty pharmacy

Material adverse change (MAC) notification
Pharmacy

Clinical guideline updates

Material adverse change (MAC) notification

Medical Policy & Clinical Guidelines

Continuing medical education/continuing education unit opportunities

Medicaid

Keep up with Medicaid news

Medicaid

Keep up with Medicare news

Medicare

Maximizing efficient, high quality COVID-19 screenings

Medicaid

Maximizing efficient, high quality COVID-19 screenings

Medicare

May is national high blood pressure education month

Administrative

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

Medicaid

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

Products & Programs

Provider bulletins for medical and itemized bill attachments

Electronic solutions @ your fingertips
Administrative

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

Administrative

Reimbursement policy update: Frequency editing (Professional)

Reimbursement Policies

Resources to support diverse patients and communities

Administrative

Send larger digital attachments through Availity

Administrative

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization

Material adverse change (MAC) notification
Pharmacy

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Updates for Specialty pharmacy effective August 1, 2021

Material adverse change (MAC) notification
Pharmacy

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines

Medicaid

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines

Medicare
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