Latest Notices and Updates


Auth Grid and Clinical Criteria
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For questions regarding participation status please contact our Customer Service teams or your Provider Service Representative.


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Changes to Medicare Advantage Prior Authorization Requirements - Effective 3/9/2020
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Changes to Prior Authorization Requirements for Transcatheter Aortic Valve Replacement (TAVR) Requests
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We are no longer including members assigned Primary Care Provider (PCP) on our Member ID cards.
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Change in Provider Contract Effective Dates - Effective January 1, 2020
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Our second event of the Acute Pain Prescribing Guidelines Learning Series is for primary care, emergency care, and dental/oral surgery providers as well as supporting care teams.
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Changes to Inpatient and Concurrent Review Process for Medicare Advantage Hospital Stays
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 Effective 1/1/20 MRI CPT codes 77046-77049 will now require a PA. 


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Medicare Medical and DME NCD/LCD edits - Effective 8/1/2019
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