09/14/2021

Priority Health Update

Priority Health Managed Care Committee Member

Flora Varga, Cancer & Hematology Centers of West Michigan

Reminder to Complete the 2021 D-SNP Model of Care Provider Training

2021 PriorityMedicare D-SNP Model of Care provider training required through CMS

Providers play an integral role in the care teams that support our dual-eligible special needs 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. Our Model of Care is a quality improvement tool that ensures the unique needs of our D-SNP members are met and describes the processes and systems we use to coordinate their care.

Who needs to complete Model of Care training?  READ ARTICLE

New Preferred Products for Medicare Part B Drugs Start Oct. 14

Starting Oct. 14, we’ll have preferred products for two classes of Medicare Part B medications: Hyaluronic Acid (HA) Derivatives and Erythropoietin Stimulating Agents (ESA).

We will require patients who have a new prescription to use the preferred products for the Medicare Part B drugs below. Members who are already using the non-preferred products may be changed to preferred products, but this will not be required.  (Includes Erythropoietin stimulating agents.)   

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