View the latest updates to Medical Clinical Policies
2026
- Important Prior Authorization Updates: Effective October 1, 2026
- Evolent Prior Authorization Updates: Effective January 1, 2027 (PDF)
- Availity Essentials Training, Live and On-Demand
- Clinical & Payment Policy Updates: Effective September 1, 2026
- Availity Essentials: New RFAI Feature
- Annual Model of Care Training Required
- Updates to Inpatient and Post-Acute Care Pre-and Post-Decision Peer-to-Peer Discussions
- CMS Launches Medicare GLP-1 Bridge Program
- Annual Special Needs Model of Care Training Notification (PDF)
- Updated Medicare Outpatient Observation Notice Now in Effect
- Reminder: Access Toll-Free Fax Numbers at wellcare.com
- Annual Wellness Visit and Routine Physical Exam Coding Refresher
- CareCentrix Medical Necessity Review Criteria Change: Effective May 1, 2026
- 2026 NCQA Annual Accreditation (PDF)
2025
- Important Prior Authorization Updates: Effective April 1, 2026 (PDF)
- Medicare Telehealth Flexibilities for Wellcare Members through 2026
- 2025 Diamond Designation™ Program Revisions (PDF)
- Provider Notice: Retirement of Patient Analytics on December 31, 2025
- Prior Authorization update for Evolent
- CMS Prior Authorization Change: Effective January 1, 2026
- Important Prior Authorization updates: Effective October 15, 2025 (PDF)
- Prior Authorization Update for Evolent: Effective January 1, 2026 (PDF)
- Medicare Prior Authorization Change Summary: Effective October 1, 2025
- CMS Prior Authorization Change Summary: Effective January 1, 2026
- Introducing Availity Editing Services (AES)
- Model of Care Training Required
