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Clinical & Pharmacy

In the “Current” tab, you’ll find news published during the past year. Use the “Archive” tab to view news going back an additional two years.

3/1/24 June 2024 Medical and Pharmacy Policy updates now available
2/22/24 Include records showing medical necessity for HTR coverage
2/15/24 Blue Cross to cover annual mental health wellness exam
2/1/24 May 2024 Medical and Pharmacy Policy updates now available
1/26/24 Answers to your questions about home health care services
1/24/24 We are postponing our monitored anesthesia care claim edits
1/16/24 Temporarily waiving auth requirements for SNFs, rehab hospitals
1/5/24 New Neuropsychological and Psychological Testing medical policy
1/1/24 April 2024 Medical and Pharmacy Policy updates now available
12/12/23 Clarification on NICU level of care authorization program
12/1/23 March 2024 Medical and Pharmacy Policy updates now available
11/28/23 Your claims for Vitamin D testing
11/22/23 New specialty pharmacy will join our network in January 2024
11/16/23 New Rx needed for discontinued Flovent Diskus and Flovent HFA
11/7/23 Care for members with intellectual, developmental disabilities
11/1/23 February 2024 Medical and Pharmacy Policy updates now available
11/1/23 Inpatient Only list will be updated on Jan 1
10/27/23 Are you billing a covered diagnosis for these tests?
10/19/23 Encourage patients to protect themselves with the flu shot
10/17/23 NICU level of care auth program begins November 1
10/12/23 Are your Medicare patients due for a colorectal cancer screening?
10/1/23 January 2024 Medical and Pharmacy Policy updates now available
9/29/23 We’re complying with new step therapy law
9/29/23 We are covering community-based emergency behavioral health care
9/27/23 The link between mental and dental health is bidirectional
9/22/23 Colonoscopy or other screening? Help your patient decide
9/13/23 Synagis benefits and coverage for 2023-24 season
9/1/23 December 2023 Medical and Pharmacy Policy updates now available
8/28/23 Sign up for NICU level of care authorization training—New dates!
8/22/23 PCPs: Stay up to date on your patients’ routine & preventive care
8/1/23 November 2023 Medical and Pharmacy Policy updates now available
7/27/23 NICU level of care authorization program delayed until Nov 1
7/13/23 Doctor—and patient—know best
7/5/23 Learn about NICU level of care authorizations and case management
7/1/23 October 2023 Medical and Pharmacy Policy updates now available
6/30/23 Personalized care & support for members diagnosed with diabetes
6/23/23 2023 information about our clinical programs
6/6/23 Work with your patient to control asthma
6/1/23 September 2023 Medical and Pharmacy Policy updates now available
5/19/23 We are postponing our monitored anesthesia care claim edits
5/8/23 Our partnership with Cricket Health is ending
5/1/23 August 2023 Medical and Pharmacy Policy updates now available
4/28/23 Quantity limits increased on generics of Adderall XR, Concerta
4/27/23 Support for Medicare Advantage patients with chronic kidney disease
4/13/23 What to know about the end of the COVID-19 public health emergency
4/3/23 Reminder: Authorization required for musculoskeletal services
4/1/23 July 2023 Medical and Pharmacy Policy updates now available
3/29/23 Preventive mammography screenings
3/3/23 Simplifying auth entry for cancer treatment