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Highmark Medical Policy Updates Available Online – November 2021

November 29, 2021

Highmark’s monthly Medical Policy Update newsletter will be available online on or before November 29. These changes may impact your patients who have moved onto Highmark’s system (beginning November 1). Policy updates described in the newsletter will be effective February 28, 2022 and can be reviewed by clicking the link below.

All medical policies for Highmark system patients can be reviewed by clicking on the link below.

Recent Articles

  • New Enumeration Form for Advanced Practice Providers (APPs) Now Live
    We previously announced a new enumeration process for Advanced Practice Providers (APPs) beginning January 1, 2022. As a reminder, APPs will no longer be required to be fully credentialed with us. To enumerate, APPs will need to complete a simple online form within Highmark’s systems.
  • Preauthorization Temporarily Waived for In-Network Hospital and Facility Transfers
    In accordance with the recent DFS Circular Letter 1 (2022), we are temporarily removing preauthorization review of all patient transfers between in-network hospitals and in-network rehabilitation and skilled nursing facilities following an inpatient stay. This temporary change will be effective for 30 days as of January 6, 2022 for your Highmark Blue Cross Blue Shield of Western New York commercial, Medicare Advantage and self-insured ASO patients*.
  • 2022 Medication Coverage Changes
    Beginning January 1, some previously prescribed medications for your Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY) Commercial and Medicare Advantage patients may have different cost-share, quantity limitations, coverage criteria, or may not be covered. In this article, you can find a list of top impacted medications.
  • $2.67 Million Awarded to Address Racial and Health Inequities
    Highmark of Western and Northeastern New York has announced a $2.76 million investment focused on addressing racial and health inequities in its local communities. This brings our total 2021 community investments and partnerships to more than $7 million as part of a commitment to invest $70 million over the next decade. Major grant recipients include Buffalo Center for Health Equity and Buffalo Go Green. Here, you can read more about these initiatives.
  • 2022 Medicare Advantage Benefit Updates
    Highmark Blue Cross Blue Shield of Western New York continues to review and adjust patient benefits to meet the needs of our membership and market demands. We want to let you know about several benefit updates for your Highmark BCBSWNY Medicare Advantage patients beginning January 1, 2022.

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