Recent news

Here is the news from the past month. For older news, click any news category.

(November 11) Facilities: 340B drug pricing program is changing to a post-payment review

(November 6) Prior auth requirements for Medicaid outpatient behavioral health therapy being removed Jan. 1, 2020

(November 1) 2020 commercial plans fee schedules are now online

(November 1) New Medicare Advantage routine vision benefit effective Jan. 1, 2020

(October 30) We'll no longer mail approval letters for urgent/emergent admissions for Medicare 

(October 29) Home health prior auth changes coming Jan. 1, 2020

(October 28) Commercial and Medicare formulary changes coming Jan. 1, 2020 

(October 24) Helpful tips for changing an existing authorization

(October 21) Changes to Medicare Advantage routine hearing benefits and network, effective Jan. 1, 2020

(October 16) MDHHS to host community forums on upcoming Healthy Michigan Plan work requirements

(October 7) Skilled nursing, long-term acute care and inpatient rehab facility admission for Medicare members to use medical authorization request form

(October 3) Facilities: Effective Oct. 1, additional services may be payable for Medicare members moved from inpatient to outpatient

(October 2) We're making changes to our remittance advice (RA) and explanation of benefit (EOB) codes for commercial and Medicare APC claims effective Nov.  1, 2019

(October 2) Changes to remittance advice (RA) and explanation of benefit (EOB) codes effective Oct. 7, 2019

(October 1) Increasing fee schedule for CPT codes 26055 and 64721 beginning Oct. 1

(October 1) New Healthy Michigan plan requirements coming Jan. 1, 2020

(September 27) Medical policy updates

(September 26) Most authorization requests moving to online submission in 2020

(September 26) Behavioral health authorization requests moving to online submission in 2020

(September 24) Reminder Medicaid CHAMPS prescriber enrollment requirement effective Oct. 1, 2019

(September 23) Reminder: Step therapy added for select Medicare Part B drugs effective Oct. 1, 2019

(September 20) MDHHS to host webinar on Healthy Michigan Plan changes coming Jan. 1, 2020

(September 17) Clarification: No changes to skilled nursing facility payments with CMS's Oct. 1 changes

(September 11) Reminder: Modifier 26 not payable for most lab services

(September 6) Michigan Medicaid formulary changes coming Oct. 1, 2019