2023
- National Epic Payer Platform Announcement
- Find-a-Provider Directory Communications: Phase 1
- NIA MSK Management Program
- Important Pharmacy Claims Processing Change, Effective January 1, 2024
- Revised Claims And Payment Policy: Leg Stent Coding
- Medicare Prior Authorization Changes Effective October 1, 2023
- Annual Special Needs Plan Model of Care (MOC) Training
- 2023 Quality Education Webinars: Series 2
- Reminder: Home Health Notice of Admission (NOA) Change
- Resources for those Affected by the Highland Park Tragedy
- Termination of Somatus Care Management Program for Patients with CKD/ESRD
- Wellcare of Illinois Ascension Complete Provider Relations Transition
- Medicare Prior Authorization Change Summary - Effective July 1, 2023
- COVID-19 Public Health Emergency (PHE) Expiration
- Appendix A - Medicare Part B Drug List - Effective July 1, 2023
- Wellcare 2023 $0 Immunizations Part D Vaccines - (PDF)
- Reminder of CMS Lab Ordering Guidelines
- New Century Health Oncology Prior Authorization List: Effective April 1, 2023
2022
- Medicare Advantage (MA) D-SNP lookalike health plans to transition to MMAI or other MA plans
- Peer-to-Peer Review Request Requirement Changes Effective October 1, 2022
- InterQual Criteria Rollout: Effective August 1, 2022
- Prior Authorization Requirement Updates: Effective March 1, 2022
2021
- National Imaging Associates (NIA) Implementation Announcement
- New Somatus Care Management Program for patients with CKD/ESRD
- CPP 161: Polymerase Chain Reaction Respiratory Viral Panel Testing
2020
- Claims and Payment Policy: Review of NOS, NEC and Unlisted Codes
- New Prepay Edits: Institutional Ambulance Claims
- Prepayment Clinical Validations Edit Policy
- CPP 171: Frequency of Comprehensive Ophthalmological Exams
- Operations - Timely Filing
- CPP 145: Incorrect Billing for Severe Malnutrition Policy
- $0 Member Liability extended for select services until end of 2020
- New Portal Features: Edit authorizations, add attachments, and more!
- DOH offers resources for diagnosis/treatment of COVID-19
