07/18/2023

Health Alliance Plan

Health Alliance Plan Managed Care Committee Member

April Danish, CHONC - Newland Medical Associates

JZ Modifier
Effective July 1, the JZ modifier must be submitted on a claim for single dose containers
where there are no discarded amounts.

For more information on discarded biologic and non-biologic drugs, please see the HAP
Provider Billing Manual.

Public Health Emergency Unwind – Update
In January, the Biden Administration announced its intent to end the national emergency and public
health emergency (PHE) related to the COVID-19 pandemic on May 11, 2023. We will follow guidelines from the Centers for Medicare & Medicaid Services (CMS) and the Michigan Department of Health and Human Services (MDHHS) unless otherwise noted. Below is a high-level overview of changes effective May 11, 2023.

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HHS-RADV Initial Validation Audit – FAQs for Provider Offices

• What is the HHS-RADV Initial Validation Audit?
• What is Risk Adjustment?
• Who is Cognisight, LLC?
• Why do I need to provide medical records?
• Do I need to comply with this request?
• How long do I have to submit medical records?
• What if I haven’t heard from Cognisight?

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Reminder - Medical Record Review Projects
HAP partners with vendors to conduct medical record reviews. They contact offices directly and
provide the review details, including due dates and submission requirements.

The tables below outline our current and upcoming medical record review projects. All reviews
are conducted by our vendor, Change Healthcare, unless otherwise noted. Provider offices could
be contacted more than once due to different regulatory projects, dates of service, and
membership.

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