News and updates

Updates on Existing CriteriaThe following changes to criteria are effective October 22, 2024:Prior Authorization Criteria – Clinical UpdatesArikayce...

Often times, patients with Alzheimer's disease or other forms of dementia are supported by a family caregiver—a valuable part of the patient’s care team. Now, these caregivers have a new...

We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after September 15, 2024.Summary of changes...

Updates on Existing CriteriaSeptember 2024. The following changes to criteria are effective September 22, 2024:Prior...

IRS Notice 2014-55 (PDF) expands the situations in which individuals may change their health coverage elections under a Section 125 (cafeteria) plan.Please note that plans are not required...

Updates on Existing CriteriaAugust 2024. The following changes to criteria are effective August 22, 2024:Prior Authorization Criteria –...

These updated documents contain policy guidance for the Medicaid Grievance and Appeals System. Grievances Appeals and Hearings Member Information and Education RequirementsNotice of Adverse...

Updates on Existing CriteriaJuly 2024. The following changes to criteria are effective July 22, 2024:Prior Authorization Criteria –...

Clearinghouse services provided by Change Healthcare have been mostly restored, including eligibility status, remittance advice, and claims transmission, following a February cybersecurity event....

Here’s what providers should know if they want to provide health-related social needs (HRSN) services.Qualifications and process for becoming an HRSN service providerTo become an HRSN service...