What's new in Network News
April 25, 2025
Florida: TurningPoint to manage prior authorization process for musculoskeletal surgical procedures
Beginning May 1, 2025, TurningPoint will manage prior authorization requests for musculoskeletal surgical procedures.
April 24, 2025
Use EDI 275 to upload claim attachments
Availity clearinghouse is now available for unsolicited EDI 275 claim attachments. See our growing list.
April 24, 2025
Zepbound and phentermine added to preferred drug list
In January 2025, we made policy updates for weight loss and obesity medications for certain Massachusetts plans.
April 24, 2025
Ohio: Use EVV platform for home health services to avoid claim denials
Register with Sandata and begin to use the state’s EVV system to avoid claim denials beginning on June 1.
April 24, 2025
New York Medicaid: Referrals not required for most specialty services
Referrals for New York Medicaid members are required for only certain specialty services. View the latest requirements.
April 23, 2025
New York Medicaid: Prenatal and postpartum services require Category II CPT® codes
Submit claims with Category II CPT codes for prenatal/postpartum services to comply with NY state guidelines.