The Cigna Group Announces Plan to Divest Medicare Advantage and CareAllies Businesses The Cigna Group announced an agreement to divest its Medicare Advantage, Cigna Supplemental Benefits (which includes Medicare Supplemental Benefits), Medicare Part D, and CareAllies businesses to Health Care Service Corporation (HCSC). This includes all their Medicare plans, networks, and customers, as well as
2024 Deleted CPT Codes Do you need a copy of the 2024 deleted CPT codes? Send an email requesting it, and we will send it to you. You will receive the codes and the AMA's recommended replacement code in this Excel sheet. Please contact MSSNY Payment & Practice with any questions you may have.
CMS Interoperability and Prior Authorization Final Rule CMS-0057-F The Centers for Medicare & Medicaid Services (CMS) affirms its commitment to advancing interoperability and improving prior authorization processes by publishing the CMS Interoperability and Prior Authorization final rule (CMS-0057-F). Through the provisions in this final rule, Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance
New Federal Independent Dispute Resolution (IDR) Administrative Fee and Certified IDR Entity Fee Ranges Posted The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury (collectively, the Departments) updated the No Surprises Act website to reflect upcoming changes to the Federal Independent Dispute Resolution (IDR) certified
NYRx E&O Update Flovent® and Advair® products continue to be included in the NYRx Brand Less Than Generic Program (BLTG). Due to recent changes announced by the manufacturer including the discontinuation of Flovent® and the decreased production of Advair®, effective December 21, 2023, the NYRx Medicaid Pharmacy Program will allow for the generics to these
Do You Have Unpaid Claims from NYC Law? If you have unpaid claims from NYC Law, please contact Heather Lopez to get additional information that could assist with this issue.
NYRx Preferred Drug Quick List For NYRx, the Medicaid Pharmacy Program, prescribers should review and prescribe preferred products whenever possible. The preferred drugs generally do not require prior authorization when prescribed according to FDA labeling, unless otherwise indicated. Please refer to the NYRx Preferred Drug Quick List for a resource containing only preferred drugs. The
NYRx Preferred Drug Quick List For NYRx, the Medicaid Pharmacy Program, prescribers should review and prescribe preferred products whenever possible. The preferred drugs generally do not require prior authorization when prescribed according to FDA labeling, unless otherwise indicated. Please refer to the NYRx Preferred Drug Quick List for a resource containing only preferred drugs. The
Federal IDR Portal Reopens On December 15, the Departments reopened the Federal IDR portal to process all dispute types, including previously initiated batched disputes, new batched disputes, and new single disputes involving air ambulance services. The Departments are granting extensions of the applicable IDR deadlines for the initiation of new batched disputes and new single
Don’t Miss Out on Exclusive Access to CMS/NGS! Monthly Meeting Time Change: CMS/NGS is enhancing member access by adjusting the schedule for their monthly meetings. Starting December 12th, these meetings will now occur from 12-1 pm on every second Tuesday of the month. This change ensures our members can conveniently address their questions and concerns.
