Neighborhood News
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Action Required
Announcements
- Delay in Home Care Gap Notification Form Implementation
- Change to Secure Email Encryption
- Update: EOHHS Guidance on Preventive Care Visits
- Asian Committee and Provider Relations Hold Outreach Training with PCHC Clinicians
Reminders
- Medicaid Redeterminations: Help Your Patients Keep Their Coverage
- Access to Care Standards
- Continuity and Coordination of Care and Communication with the Primary Care Practitioner
- Concurrent Review Process
- Encourage Patient Enrollment in CurrentCare
Quality Improvement
- HEDIS Plan All-Cause Readmissions (PCR) Measure Guide
- Cervical Cancer Awareness
- Human Papillomavirus (HPV)
- Increasing Health Literacy to Improve Health Outcomes
- Asthma Medication Ratio
Payment Policy Updates
Behavioral Health
Risk Adjustment
Claims
- Update: Form CMS-1500 Requirements for Neighborhood
- Notice of Electronic Claim Submission Requirement
- Current Forms
- Continued Claims
- Claim Submission Reminders for Providers and Billers
Pharmacy
- Notice of Change to G-CSF First Treatment Strategy
- Pharmacy Webpage Restructuring
- Upcoming Pharmacy Benefit Changes for Inhaler and Insulin Products
- Pharmacy Benefit Medicaid Drug Rebate Program (MDRP)
- How to Bill 340B Appropriately
- Electronic Prior Authorization for the Pharmacy Benefit
- Medical Benefit Prior Authorization Submission
- Specialty Medication Prior Authorization Criteria
- Opioid Prescribing and Alternative Therapies for Neighborhood INTEGRITY Members
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
- Requests for Out-of-Network Pharmacy Services
- Medicaid and Commercial Limited Specialty Pharmacy Network
Monthly Pharmacy Benefit Changes: On a monthly basis, Neighborhood places a list of formulary changes on its website for each line of business. For more information, please visit the Pharmacy Provider Resources webpage at: https://www.nhpri.org/providers/provider-resources/Pharmacy/