Change Healthcare – latest updates

Reminder: Centers for Medicare & Medicaid Services prohibition on billing Qualified Medicare Beneficiaries

December 23, 2024

Federal law prohibits all Medicare providers and suppliers, including pharmacies, from billing Medicare beneficiaries in the Qualified Medicare Beneficiary (QMB) eligibility group for Medicare Part […]

Provisional provider Medicaid enrollment process for Florida

December 23, 2024

Due to Hurricane Milton, the Florida Agency for Health Care Administration has directed health plans to implement a provisional provider Medicaid enrollment process for providers. […]

Pharmacy update: Extension to prescribe alternative medication due to UDENYCA shortage

December 20, 2024

Due to the ongoing manufacturing shortage of UDENYCA®, Cigna HealthcareSM has extended the approval date for prescribing the alternative medication, NYVEPRIA™, through February 19, 2025. […]

Maryland access to evaluation/treatment requirements

December 18, 2024

The Maryland Insurance Administration requires in-network providers to have policies and procedures in place to ensure that customers can be evaluated and/or treated for urgent* […]

2025 Clinical, reimbursement, and administrative policy updates

December 13, 2024

To support access to quality, cost-effective care for your patients with a medical plan administered by Cigna Healthcare, we routinely review clinical, reimbursement, and administrative […]

California HMO provider appointment access and availability

December 11, 2024

When patients receive the right care at the right time, it can result in better health outcomes and an improved care experience. The State of […]

Changes for Part D Measures to 2025 Measurement Year for the 2027 Star Ratings

December 11, 2024

The Centers for Medicare and Medicaid Services (CMS) finalized the addition of two new Part D measures for the 2025 measurement year. Both were developed […]

Update to prior authorization requirements for partial hospitalization level of care effective January 1, 2025

December 10, 2024

Evernorth® Behavioral Health (Evernorth) is committed to helping health care providers deliver timely care to patients by reducing the administrative burden. Therefore, effective January 1, […]

Policy and coverage updates

December 9, 2024

Cigna Healthcare coverage policies can help you to interpret standard health coverage plan provisions. Access the latest updates. 

NALC Health Benefit Plan AMIs to change in January

December 8, 2024

Effective January 1, 2025, the alternate member identifiers (AMIs) for your patients with health care coverage under the National Association of Letter Carriers Health Benefit […]

New guest access to HealthPartners provider portal

December 6, 2024

HealthPartners, a Cigna HealthcareSM strategic partner, has implemented a simplified way for providers to verify customer eligibility on their portal without registering for an account. […]

Follow-Up Care for Children Prescribed ADHD Medication HEDIS measure (ADD)

December 4, 2024

Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral health disorders affecting children. The main features include hyperactivity, impulsiveness, and an inability […]

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