Responsibilities and standards news

Annual pSA renewal process

Our annual prism Security Administrator (pSA) renewal period is underway. pSAs will have until Aug. 1 to review and either approve or deny all user affiliations for your group or facility.

June 27, 2025

Read article
May 2025 medical policy updates

Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in May and approved a series of medical policy updates.

June 27, 2025

Monthly record retrieval for the 2025 DBM program

Our Risk Adjustment team will start monthly email outreach to our Disease Burden Management (DBM) Program providers to collect medical records for targeted DBM members who’ve completed a visit with a provider.

June 27, 2025

You must complete our DSNP MOC training

Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.   

June 27, 2025

We're collecting records for our Medicare retrospective chart review

Our Medicare retrospective chart review kicks off soon

June 27, 2025

Provider reenrollment for the VFC program closes on April 1

Provider reenrollment for the VFC program closes on April 1

June 27, 2025

February 2025 medical policy updates

Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in February and approved a series of medical policy updates.

June 27, 2025

2025 D-SNP MOC training is now available

Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.   

June 27, 2025

Medicaid formulary changes coming Feb. 1, 2025

New Medicaid formulary changes coming Feb. 1, 2025

June 27, 2025

NCQA's 2025 HEDIS audit is underway

2025 HEDIS audit is happening now

June 27, 2025