News and updates

The COVID-19 National Emergency and PHE ended on May 11, 2023. Our FAQ provides a brief overview of changes for Medicare and Medicaid providers. The FAQ includes: Answers to general questions An...

Updates on Existing Criteria July 2023. The following changes to criteria are effective July 22, 2023:  Prior Authorization Criteria – Clinical...

Updates on Existing Criteria June 2023. The following changes to criteria are effective June 22, 2023:  Prior Authorization Criteria – Clinical Updates...

After a three-year pause, the process of checking member eligibility for renewing Medicaid health insurance coverage has begun again. It’s estimated that anywhere between 5 and 15 million people are...

Updates on Existing Criteria May 2023. The following changes to criteria are effective May 22, 2023:  Prior Authorization Criteria – Clinical Updates...

The Centers for Disease Control, Oregon Health Authority, and the Centers for Medicare and Medicaid Services recommend clinicians carefully assess benefits and risks of prescribing high doses of...