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July 2024
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Tricia A. Keith to succeed Daniel J. Loepp as president and CEO of Blue Cross Blue Shield of Michigan

On May 15, 2024, Blue Cross Blue Shield of Michigan’s Board of Directors appointed Tricia A. Keith, pictured at left, to succeed Daniel J. Loepp as president and CEO on Jan. 1, 2025, following his retirement. Read more.


Inside this issue for you

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See all the articles in this issue, grouped by category, below.

Professional
Register now for our virtual Behavioral Health Summit
Webinars for physicians, coders focus on risk adjustment, coding
Changes coming for select weight loss drugs for some commercial members
Medicare Advantage prior authorization criteria changed for some diabetes drugs
Outpatient audits of Medicare Plus Blue professional claims to begin in October
Keep this information in mind when it comes to therapeutic massage
Help patients manage chronic conditions
We’ll use 2024 InterQual criteria, starting Aug. 1
Select one PO with affiliated MCG to support all Blue Cross, BCN business
Changes coming to prior authorization process for post-acute care services for Medicare Advantage members
Remember this information about reimbursement for manual therapy
Requirements, codes changed for some medical benefit drugs
Do you have time for a Quality Minute?
Medicare implantable ambulatory event monitors questionnaire removed from e-referral system
Soliris, Ultomiris to require step therapy for commercial members
Dapagliflozin, generic for Farxiga, isn’t covered for Medicare Advantage plans
Hemlibra has a quantity limit requirement for most commercial members
Loqtorzi to have requirements for most members, starting Aug. 15
Step therapy requirement added for botulinum toxins for Medicare Advantage members, starting Aug. 5
Step therapy requirement added for Saphnelo for Medicare Advantage members Sept. 1
Syfovre, Izervay, Elfabrio to have requirements for URMBT members with non-Medicare plans
Article correction: Spevigo SC has requirements for most commercial members, starting April 25
All Providers
Facility
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.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2023 American Medical Association. All rights reserved.

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