Prepaid health plans are required to pay interest and penalties to providers if they fail to accurately pay or inappropriately deny a claim.
Topics Related to All Providers
Topics include key dates, playbook updates, prior authorization, FAQs, contracting, ombudsman, webinars and more.
Effective Oct. 15, 2021, CDSAs and independent practitioners providing individualized family service plan services must resume submitting PA requests.
Effective Aug. 18, 2021, the Medicaid and NC Health Choice programs cover anifrolumab-fnia injection
Providers are encouraged to confirm which PA types are included in this long-term design.
Tobacco-related policy requirements go into effect on July 1, 2022.
Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis
Will cover all U.S. FDA approved CAR T-Cell Therapies when administered per U.S. FDA approved guidelines
Temporary Suspension of Prior Authorization for Post-Acute Placements and Temporary Availability of the Hospital at Home Program