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
