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Medicaid

Medicare

  • Claims & Payment Policy (#133): 340B Drug Payment Reduction Policy
  • WellCare and Absolute Total Care are joining health plans
  • New Medicare ID cards for 2020
  • Reducing Low Value Care Screenings Claims Edit Guidelines Policy
  • Dialysis Claims Payment Policy
  • Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy
  • Emergency Department (ED) High Acuity Radiology Utilization Reimbursement Policy
  • Medicare Milliman Clinical Guidelines (MCG) Rollout
  • New Urine Drug Testing Guidelines
  • Prior Authorization Requirements
  • Medicare Star Ratings Call to Action
  • Annual Wellness Visit and Additional Annual Physical Coding Refresher
  • Dual SNP Cost-Sharing Update
  • Readmission Policy Update
  • New Modifier Claims Edit Guideline (CEG)
  • Prior Authorization Requirements
  • Important update to the clinical coverage guideline for Post-Acute Care
  • HealthHelp
  • New Medicare Cards
  • Exciting Authorization Rule Enhancements
  • Your Partner in Quality Care
  • Pharmacy Benefit Manager Effective January 1, 2016
  • ICD-10 Transition Effective October 1, 2015
  • Inpatient Readmission Policy
  • Coding Reminder: Modifier 25
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    Last Updated On: 3/25/2020