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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.

6/6/25 New in-home program for complex Medicare Advantage members
6/2/25 Collaborating with you across the mental health continuum of care
6/1/25 September 2025 Medical and Pharmacy Policy updates now available
5/29/25 GLP-1 medications for obesity: Coverage update
5/6/25 Colorectal cancer screening kits to be sent to your patients
5/1/25 August 2025 Medical and Pharmacy Policy updates now available
4/17/25 Some GLP-1 medications to be benefit excluded: Offering employers choice for continued coverage
4/1/25 July 2025 Medical and Pharmacy Policy updates now available
3/26/25 Write 100-day prescriptions for Medicare Advantage members
3/19/25 Encourage patients to use their blood pressure monitors
3/3/25 A $0 cost share now applies to additional HIV PrEP meds
3/1/25 June 2025 Medical and Pharmacy Policy updates now available
2/3/25 New in-home bone mineral density screening program
2/1/25 May 2025 Medical and Pharmacy Policy updates now available
1/17/25 No auth needed for speech therapy for Medicare HMO Blue members
1/1/25 April 2025 Medical and Pharmacy Policy updates now available
12/6/24 Encompass Fertility specialty pharmacy has closed
12/3/24 Immunization information for the 2024-2025 cold and flu season
12/1/24 March 2025 Medical and Pharmacy Policy updates now available
11/21/24 Reminder: Change to pharmacy medical policy 056 related to GLP-1
11/20/24 We’re sending test kits to members for A1c, blood pressure, & kidney health
11/12/24 Habilitation services do not require authorization
11/1/24 Helping patients with diabetes get important retinal screenings
11/1/24 February 2025 Medical and Pharmacy Policy updates now available
11/1/24 Inpatient Only list will be updated on Jan 1
10/23/24 Colorectal cancer screening kits have been sent to your patients
10/1/24 January 2025 Medical and Pharmacy Policy updates now available
9/6/24 Submit NICU claims at level of care approved
9/4/24 Schedule wellness visits with your Medicare Advantage patients
9/3/24 Reminder on NCD/LCD policies for Medicare Advantage members
9/1/24 December 2024 Medical and Pharmacy Policy updates now available
8/29/24 Coordinating medical and mental health care for better health outcomes
8/28/24 Help your patients control their blood pressure
8/27/24 We’re encouraging your patients to have routine & preventive care
8/16/24 Submit required clinical to avoid delays in auth processing
8/1/24 November 2024 Medical and Pharmacy Policy updates now available
8/1/24 We launched a doula pilot program! Here’s what you need to know.
7/23/24 2024 information about our clinical programs
7/11/24 Should your patient take a statin medication?
7/1/24 October 2024 Medical and Pharmacy Policy updates now available