03/06/2018

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Changes to our National Precertification List (NPL)
• Request precerts electronically — it’s fast, secure and simple
• Ordering genetic tests in the correct sequence will result in fewer denials
• Changes to commercial drug lists begin on July 1, 2018

And Much More….MARCH Mid-America Region Qtly Issue Available HERE

A Few Articles You Won’t Want to Miss:

• Blue Cross and BCN changing professional provider consultant model
• BCN medical directors are a resource for physicians
• Prevent unnecessary delays: Include key information for oncology medications

And Much More…MARCH/APRIL Bi-Monthly Issue Available HERE

Current Issue Available HERE

Current Issue Available HERE   (once on the site, choose NEWS on the left side)

A Few Articles You Won’t Want to Miss:

• Your Completion of Provider Compliance Training Materials is Important
• Review Available Policies on Prior Authorization, Quantity Limits and Step Therapy
• New Medicare Member ID Numbers Begin Rolling Out in April
• New and Revised Pharmacy and Medical Coverage Policies Available

And Much More…Latest Issue Available HERE

 A Few Articles You Won’t Want to Miss:

• Front & Center
  • Updates to Notification/Prior Authorization Requirements for Specialty Medications for UnitedHealthcare Commercial and Community Plan Members
  • Denosumab (HCPCS code J0897) Will Require Prior Authorization

• UnitedHealthcare Community Play
  • UnitedHealthcare Community Plan Medical Policy, Medical Benefit Drug Policy and Coverage Determination Guideline Updates

• UnitedHealthcare Medicare Advantage
  • UnitedHealthcare Medicare Advantage Coverage Summary Updates

And Much More…MARCH Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Policy Updates

Updated:

• Platelet Derived Growth Factors for Treatment of Wounds - Effective Mar. 1, 2018
• Proton Beam Radiation Therapy - Effective Mar. 1, 2018

Revised:

• Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions - Effective Apr. 1, 2018

Medical Drug Benefit Policy Updates

New:

• Denosumab (Prolia® & Xgeva®) - Effective Mar. 1, 2018

Updated:

• Orencia® (Abatacept) Injection for Intravenous Infusion - Effective Mar. 1, 2018

Utilization Review Guideline (URG) Updates

Updated:

• Immune Globulin Site of Care Review Guidelines for Medical Necessity of Hospital Outpatient Facility Infusion - Effective Apr. 1, 2018

Revised:

• Chemotherapy Observation or Inpatient Hospitalization - Effective Apr. 1, 2018
• Office Based Program - Effective Apr. 1, 2018
• Hospital Readmissions - Effective Apr. 1, 2018

MARCH Monthly Issue Available HERE