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November 2023
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Blue Cross and BCN receive 4-Star ratings from CMS
The Centers for Medicare & Medicaid Services recently announced its 2024 Medicare Star Ratings. Both our BCN Advantage℠ HMO plan and our Medicare Plus Blue℠ PPO plan captured 4-Star ratings, making our plans once again among the highest rated Medicare Advantage plans in the country. Read more.


Inside this issue for you

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See all the articles in this issue, grouped by category, below.
Professional
2 new Medicare Plus Blue plans can help members save in 2024
New enhanced benefits will be available to Medicare Advantage members in 2024
We’re making some changes in behavioral health processes beginning Jan. 1
Washtenaw County Community Mental Health joins crisis services program
Here are some claim editing reminders
Reminder: Signature required on medical records
Update: Starting Jan. 1, 2024, all DME codes will be removed from the CareCentrix HIT and AIS program
Northwood to manage outpatient diabetes supplies for some members, starting Jan. 1
Some diabetes drugs to require prior authorization for Blue Cross and BCN members, starting Jan. 1
Blue Cross and BCN covering additional vaccines
Updated COVID-19 vaccines approved by FDA
Requirements and codes changed for some medical benefit drugs
Starting Jan. 1, we’ll change how we cover some drugs on Clinical, Custom, Custom Select and Preferred drug lists
Changes coming to preferred drug designations under medical benefit for most commercial members
We’ve updated how we calculate MME measurements for certain opioids
Lumoxiti no longer requires prior authorization
Beyfortus to have quantity limits for commercial members, starting Jan. 1
Zynyz to require prior authorization for most members, starting Dec. 10
Starting Jan.1, prior authorization no longer required for some procedures
Here’s an update on high-intensity in-home care program through Landmark
Newly enrolled PAs and NPs required to identify their work settings to help avoid payment issues
Update: TurningPoint medical policies for musculoskeletal and pain management procedures
Reminder: Independent labs must provide advance notice to Blue Cross commercial members before providing noncovered services
Here’s information and resources to share with patients about flu vaccine
University of Michigan retirees can join our Medicare Advantage plans, effective Jan. 1
Updated on-demand training available: e-referral, risk adjustment, ICD-10-CM coding
Lunch and learn webinars for physicians and coders focus on risk adjustment, coding
All Providers
Facility
New enhanced benefits will be available to Medicare Advantage members in 2024
Know guidelines for trauma activation billing and reimbursement
We’re making some changes in behavioral health processes beginning Jan. 1
Washtenaw County Community Mental Health joins crisis services program
Reminder: Signature required on medical records
Update: Starting Jan. 1, 2024, all DME codes will be removed from the CareCentrix HIT and AIS program
Northwood to manage outpatient diabetes supplies for some members, starting Jan. 1
Some diabetes drugs to require prior authorization for Blue Cross and BCN members, starting Jan. 1
Updated COVID-19 vaccines approved by FDA
Requirements and codes changed for some medical benefit drugs
Starting Jan. 1, we’ll change how we cover some drugs on Clinical, Custom, Custom Select and Preferred drug lists
Changes coming to preferred drug designations under medical benefit for most commercial members
Lumoxiti no longer requires prior authorization
Beyfortus to have quantity limits for commercial members, starting Jan. 1
Zynyz to require prior authorization for most members, starting Dec. 10
Facilities must submit appeals within required time frames
Update: TurningPoint medical policies for musculoskeletal and pain management procedures
Reminder: Independent labs must provide advance notice to Blue Cross commercial members before providing noncovered services
University of Michigan retirees can join our Medicare Advantage plans, effective Jan. 1
Lunch and learn webinars for physicians and coders focus on risk adjustment, coding
For BCN news and information, see the current issue of BCN Provider News.

For news and information about our strategic goals and initiatives, see the current issue of Hospital and Physician Update.

To subscribe to any of our newsletters for health care providers, click here.

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