04/02/2019

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Changes to our National Precertification List (NPL)
• Changes to commercial drug lists begin on July 1, 2019

And Much More….MARCH OfficeLink Updates Qtly Issue Available HERE

A Few Articles You Won’t Want to Miss:

• Clinical review decisions are based solely on appropriateness of care
• Network guidelines for member access
• BCN medical directors are a resource for physicians
• Medical policy updates
• Blue Care Network evaluates appropriateness of E&M coding
• Starting May 1, additional radiology services require authorization by AIM for BCN and Blue Cross members

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

Current Issue Available HERE

Current Issue Available HERE 
(Once on the site, scroll to the bottom and choose NEWS on the left side)

A Few Articles You Won’t Want to Miss:

• Humana Updates Preauthorization and Notification Lists for 2019
• Changes Announced for 2019 Humana Formularies
• 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 Requirements for Specialty Medical Injectable Drugs for UnitedHealthcare Commercial, Community Plan and Medicare Advantage Members
  • Changes in Advance Notification and Prior Authorization Requirements
  • More Fax Numbers Used for Medical Prior Authorization Will Retire July 1, 2019
  • Prior Authorization Required for Therapeutic Radiopharmaceuticals

And Much More…APRIL Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Policy Updates

Updated:

• Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions – Effective Apr. 1, 2019

Medical Benefit Drug Policy Updates

Updated:

• Clotting Factors, Coagulant Blood Products & Other Hemostatics – Effective Apr. 1, 2019
• Infliximab (Remicade®, Inflectra™, Renflexis™) – Effective Apr. 1, 2019
• Ketamine – Effective Apr. 1, 2019
• Self-Administered Medications List – Effective Apr. 1, 2019
• Trogarzo™ (Ibalizumab-Uiyk) – Effective Apr. 1, 2019

Revised:

• Actemra® (Tocilizumab) Injection for Intravenous Infusion – Effective Apr. 1, 2019
• Denosumab (Prolia® & Xgeva®) – Effective Apr. 1, 2019
• Ocrevus™ (Ocrelizumab) – Effective Apr. 1, 2019
• Orencia® (Abatacept) Injection for Intravenous Infusion – Effective Apr. 1, 2019
• Rituximab (Rituxan® & Truxima®) – Effective Apr. 1, 2019
• Simponi Aria® (Golimumab) Injection for Intravenous Infusion – Effective Apr. 1, 2019
• Stelara® (Ustekinumab) – Effective Apr. 1, 2019

Utilization Review Guideline (URG) Updates

Revised:

• Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Care – Effective Apr. 1, 2019

APRIL Monthly Issue Available HERE