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PROVIDER NEWSMAINE PROVIDER NEWS MAINE PROVIDER NEWS MAINE Provider Home Archive Select Market Subscribe to Email Provider News Your digital resource for all news and announcements related to policy updates, digital tools, reimbursement and prior authorization changes, educational opportunities, and more. View the current newsletter Search Submit Search FILTER BY DATE After Date - Before Date * Recent Updates CATEGORIES * Administrative * Digital Solutions * Behavioral Health * Education and Training * Webinars * Policy Updates * Medical Policy & Clinical Guidelines * Prior Authorization * Reimbursement Policies * Products & Programs * Dental * Federal Employee Program (FEP) * Pharmacy * State Health Benefit Plan * Quality Management * Optimizing HEDIS & STARS * State & Federal -------------------------------------------------------------------------------- * AMH Health, LLC | Medicare Advantage * Anthem Blue Cross and Blue Shield | Commercial * Anthem Blue Cross and Blue Shield | Medicare Advantage -------------------------------------------------------------------------------- * Notices of Material Changes/Amendments to Contract -------------------------------------------------------------------------------- RECENT PUBLICATIONS 1. March 2024 Provider Newsletter 2. February 2024 Provider Newsletter 3. January 2024 Provider Newsletter 4. December 2023 Provider Newsletter 5. November 2023 Provider Newsletter 6. View All Publications » -------------------------------------------------------------------------------- * Provider Home * Archive * Subscribe to Email -------------------------------------------------------------------------------- Change MarketChange Market--------CaliforniaColoradoConnecticutGeorgiaIndianaKentuckyMaineMissouriNevadaNew HampshireNew YorkOhioPennsylvaniaVirginiaWisconsin Highlights KEY UPDATES Administrative / Digital Solutions | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage / AMH Health, LLC | Medicare Advantage | Mar 5, 2024 CHANGE HEALTHCARE CYBERSECURITY UPDATE – MARCH 5, 2024 -------------------------------------------------------------------------------- What's New RECENT UPDATES DateCategory Policy Updates / Prior Authorization | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage / AMH Health, LLC | Medicare Advantage | Mar 19, 2024 Notice of material change/amendment to contract Carelon Medical Benefits Management, Inc. genetic testing code updates Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 19, 2024 HEDIS ECDS Coding Booklet 2024 - Medicare Education and Training / Webinars | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 14, 2024 Roster Automation Template and Rules of Engagement training Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 14, 2024 Social Need Screening and Intervention (SNS-E) Quality Management / Optimizing HEDIS & STARS | AMH Health, LLC | Medicare Advantage | Mar 14, 2024 Social Need Screening and Intervention (SNS-E) Administrative | Anthem Blue Cross and Blue Shield | Commercial | Mar 12, 2024 Important reminder: The correct original claim number must be included if submitting a corrected claim Policy Updates / Prior Authorization | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 11, 2024 Prior authorization requirement changes effective July 1, 2024 Quality Management | Anthem Blue Cross and Blue Shield | Medicare Advantage / AMH Health, LLC | Medicare Advantage | Mar 8, 2024 HEDIS 2024 documentation for Colorectal Cancer Screening (COL-E) Administrative / Digital Solutions | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage / AMH Health, LLC | Medicare Advantage | Mar 5, 2024 Change Healthcare cybersecurity update – March 5, 2024 Policy Updates / Medical Policy & Clinical Guidelines | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 4, 2024 Medical Policies and Clinical Utilization Management Guidelines update Policy Updates / Medical Policy & Clinical Guidelines | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 1, 2024 Carelon Medical Benefits Management, Inc. genetic testing code updates Quality Management | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Encourage Cervical Cancer Screening (CCS) Education and Training | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Congenital syphilis intervention opportunities for neonatal and pediatric providers Quality Management | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Cervical Cancer Screening (CCS) and Prenatal and Postpartum Care (PPC) for HEDIS Quality Management | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Boost annual preventive care visits: Tips and resources: An ounce of prevention is worth a pound of cure Administrative | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 1, 2024 CAA: Maintain your online provider directory information Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 1, 2024 Overview of Medicare risk adjustment in-office prospective programs Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Medicare Advantage | Mar 1, 2024 Overview of Medicare risk adjustment in-office prospective programs Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Pharmacy information available on our provider website Policy Updates / Prior Authorization | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract Precertification list change notification — March 1, 2024 Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Important information about your Anthem patients’ Botox prescriptions Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract Clinical Criteria updates for specialty pharmacy Policy Updates / Reimbursement Policies | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract New reimbursement policy: Bundled Supplies and Services – Facility Policy Updates / Reimbursement Policies | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract Reimbursement policy update: Laboratory and Venipuncture Services – Professional and Facility Policy Updates / Reimbursement Policies | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract Reimbursement policy update: Ambulance Transportation – Professional Administrative / Digital Solutions | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Expansion of Carelon Medical Benefits Management, Inc. programs Administrative | Anthem Blue Cross and Blue Shield | Commercial | Mar 1, 2024 Notice of material change/amendment to contract Notices of material changes/amendments to contract — March 2024 Administrative / Digital Solutions | AMH Health, LLC | Medicare Advantage | Feb 29, 2024 Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024 Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 25, 2024 Breast Cancer Screening (BCS-E) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 25, 2024 Breast Cancer Screening (BCS-E) Administrative / Digital Solutions | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage / AMH Health, LLC | Medicare Advantage | Feb 25, 2024 Change Healthcare cybersecurity update Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 23, 2024 Adult Immunization Status (AIS-E) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 23, 2024 Adult Immunization Status (AIS-E) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Commercial / Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 23, 2024 Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 23, 2024 Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Commercial | Feb 22, 2024 Notice of material change/amendment to contract Specialty pharmacy updates — March 2024 Administrative / Digital Solutions | Anthem Blue Cross and Blue Shield | Commercial | Feb 21, 2024 Beginning February 2024, you can submit Physical Health prior authorizations through the Authorization application on Availity.com Quality Management | Anthem Blue Cross and Blue Shield | Commercial | Feb 21, 2024 Resources to Control High Blood Pressure (Hypertension) Quality Management | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 21, 2024 Resources to Control High Blood Pressure (Hypertension) Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Commercial | Feb 20, 2024 Notice of material change/amendment to contract Prior authorization updates for therapeutic duplication of specialty drugs Policy Updates / Medical Policy & Clinical Guidelines | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 20, 2024 Clinical Criteria updates — December 2023 Products & Programs / Pharmacy | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 16, 2024 Anthem expands specialty pharmacy precertification list Policy Updates | AMH Health, LLC | Medicare Advantage | Feb 16, 2024 MCG Care Guidelines 27th edition update Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 7, 2024 Health Outcomes Survey Quality Management | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 6, 2024 HEDIS® 2024 documentation for Care of Older Adults (COA) Quality Management | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 6, 2024 HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC) Quality Management | Anthem Blue Cross and Blue Shield | Commercial | Feb 6, 2024 HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 6, 2024 Health Outcomes Survey: Management of Urinary Incontinence in Older Adults (MUI) Quality Management / Optimizing HEDIS & STARS | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 2, 2024 Health Outcomes Survey: Physical Activity in Older Adults (PAO) Policy Updates / Prior Authorization | Anthem Blue Cross and Blue Shield | Medicare Advantage | Feb 1, 2024 Prior authorization requirement changes effective May 1, 2024 Codes G0481 - G0483