June 2023 Provider News
Date: 06/30/23
In this issue:
- General Updates - Contraception Coverage, After-Pregnancy Coverage (HCA)
- Quality - Medicaid & Ambetter: ADHD, Mammograms, Telehealth and Antidepressant Medication Management, Medicare: Alzheimer’s Association and Men’s Health Month
- Tribal - Checking Member Eligibility
- Payment & Clinical Policy - List of updates effective July 1
- Wellcare - Reminders: Prior authorizations and Part B drugs - effective July 1
- Apple Health Core Connections - AHCC Reunification Program: Supporting Parents When Their Children Return Home
- Training/Education - Health Equity Series, Substance Misuse and Suicide, ACE Talk with Family and Friends Workshop
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General Updates
Contraception Coverage
The Affordable Care Act (ACA) helps make prevention affordable and accessible for all Americans by requiring health plans to cover preventive services and eliminating cost sharing for those services. This legislation specifically includes women’s preventive services and coverage for all FDA-approved contraceptive methods as prescribed by a physician, as well as counseling for all women. Learn more.
Coordinated Care (including Apple Health and all Ambetter plans) offers the following FDA-approved contraceptive methods and services without limitation, generic or brand medications, at no cost to our members as required by the law:
- Contraceptive counseling
- Contraception methods
- Barrier Methods:
- Male condoms
- Female condoms
- Diaphragm with spermicide
- Sponge with spermicide
- Cervical cap with spermicide
- Spermicide alone
- Provider-assisted LARC methods ((includes all LARC (Long-Acting Reversible Contraception) as well as all services related to prescribed method):
- Intrauterine devices (IUD)
- Hormone contraceptive injections
- Inserted contraceptive devices
- Implanted contraceptive devices
- Shot/injections
- Oral and OTC contraception includes (as prescribed by a health care provider, formulary with no authorization and without limitation. Non-formulary covered through prior authorization process. Verify through Preferred Drug List.):
- The pill (combined pill and extended/continuous use):
- The mini pill
- Patch
- Vaginal contraceptive ring
- Emergency contraception (EC), known commonly as “the morning after pill” (Coordinated Care offers EC to all its members with no prescription)
- Tubal ligation (includes services related to this procedure)
- Vasectomy (includes services related to this procedure)
- Barrier Methods:
Please visit the latest Preferred Drug List (PDL) for more information:
1-877-644-4613 TTY 711 CoordinatedCareHealth.com
After-Pregnancy Coverage (APC)
Apple Health (Medicaid) After-Pregnancy Coverage (APC) offers services to help members recover mentally, physically, and emotionally after a pregnancy in the last 12 months.
Benefits and Services
APC offers postpartum follow-up care and provides additional services including dental, contraception, preventive care, behavioral health, and other services covered by Apple Health up to 12 months after pregnancy ends. Visit hca.wa.gov/apple-health-services to learn what services are covered under Apple Health.
Am I eligible?
To be eligible for the APC program you must:
- Have been pregnant within the last 12 months,
- Reside in Washington,
- Have countable income equal to or below 193 percent of the Federal Poverty Level*, and
- Not be eligible for a different Apple Health program.
Single person | 2-person household | 3-person household |
|---|---|---|
| $2,243 monthly | $3,022 monthly | $3,800 monthly |
4-person household | 5-person household | 6-person household |
|---|---|---|
| $4,579 monthly | $5,358 monthly | $6,137 monthly |
*Income limit in table includes the 5% income disregard.
Are you pregnant and already have Apple Health coverage?
- If you have coverage through Washington Healthplanfinder, report your pregnancy at wahealthplanfinder.org for a smooth transition to APC coverage.
- If you are covered by Apple Health Classic Medicaid (age 65 or older, have blindness or a disability) report your pregnancy through washingtonconnection.org.
Were you pregnant in the last 12 months and don’t have Apple Health coverage?
You may be eligible for APC. Apply now!
- Online: Go to wahealthplanfinder.org - select the "Apply Now" button.
- Mobile app: Download the WAPlanfinder app – select “sign in” or “create an account”.
- Phone: Call the Washington Healthplanfinder at 1-855-923-4633.
- Paper: Download the application.
- In-person: Local resources who, at no additional cost, can help you apply for health coverage.
If you need an accommodation, or require documents in another format or language, please call 1-800-562-3022 (TRS: 711)
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Quality
Medicaid Quality
ADHD Follow Up on Kids
Children with new prescription for ADHD medication should receive a follow up visit within 30 days of starting the medication.
Asthma and 90 Day Medication Refills
Moving members with asthma prescriptions to 90-day medication refills may increase their maintenance medication adherence.
Mammograms (HEDIS Measure)
The HEDIS measure assesses women ages 50-74 who had at least one mammogram to screen for breast cancer in the past 2 years.
Telehealth
Telehealth increases access to physicians and specialists to help patients receive the right care, at the right place, at the right time.
Telehealth resources for providers
Antidepressant Medication Management (HEDIS Measure)
The HEDIS measure assess adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on their antidepressant medications.
Wellcare Quality
Alzheimer’s Association
According to the Alzheimer’s Association there are more than 55 million people worldwide living with Alzheimer’s or another dementia.
It is estimated that one person develops Alzheimer's disease in the United States every 65 seconds. Without changes to that occurrence rate, the number will grow to roughly 76 million by 2023.
Alzheimer’s disease and other dementia-related illnesses impact every ethnic and cultural group, but they do not impact all groups in the same way. Groups may have different barriers or difficulties resulting from their own historical experiences, challenges, and trauma, including the LGBTQ+ community.
In the United States, more than 16 million people take care of family or friends with Alzheimer's or another dementia. Approximately 350,000 LGBTQ+ Americans live with dementia and are 29% more likely to report memory loss and confusion than heterosexual cisgender counterparts. Researchers believe factors might be higher rates of clinical depression, PTSD, discrimination leading to unemployment, lack of public housing and a lack of culturally informed healthcare providers leading to poorer health outcomes. Additionally, older LGBTQ+ Americans are more likely to live alone and not have assistance from a caregiver.
It is estimated that 6.2 million of those diagnosed with Alzheimer's disease are over the age of 65.
Alzheimer's disease is the 6th leading cause of death in the United States, accounting for death in one of three seniors.
Treatment costs are high for Alzheimer’s dementia and other dementias. In 2050 it is estimated the treatment cost for Alzheimer’s dementia will balloon to $1 trillion dollars.
Potential early warning signs to educate your patients:
- Loss of Sense of Smell
- People with Alzheimer's Disease often lose their ability to smell - which is often one of the first early signs many people report experiencing.
- Linked to Heart Disease
- Heart disease can play a role in heightening your Alzheimer's risk, due to the vascular dementia stemming from a narrowing of blood vessels in the brain, caused by low levels of oxygen.
- Difficulty performing everyday tasks such as keeping track of monthly bills, following a recipe while cooking. People may find it hard to concentrate on tasks, take longer to perform them or have trouble finishing them.
- Repetition of questions or telling the same story about a recent event several times.
- Personality changes- when a person begins acting unusually anxious, confused, fearful/suspicious or becomes easily upset or depressed is cause for concern.
Provider interventions to offer members:
- Encourage your patients to get screened
- The National Memory Screening Program allows your patients to answer a list of questions to see if they or someone you may know, may potentially have Alzheimer's Disease. Members who have a smart phone, laptop, tablet or any device with a webcam and internet can call 866-232-8484 for an appointment.
- Memory screenings by Providers are covered by Medicare as part of the Medicare Wellness Program.
Men’s Health Month
Men’s Health Month in June, encourages males to implement healthy lifestyle decisions to improve their overall health. Many diseases like heart disease and cancer disproportionately impact men, but are preventable through regular doctor’s visits and healthy lifestyle choices.
According to the US Department of Health and Human Services’ Office of Minority Health, US men in general are expected to live nearly six years less than women, and non-Hispanic Black and American Indian/Alaska Native men have a lower life expectancy than non-Hispanic white men.
A 2022 survey conducted by the Cleveland Clinic, issued as part of their MENtion It ® campaign, found 53% of White men and 63% of men of color do not get regular health screenings, 77% of all men did not know their complete family history pertaining to urological issues, and 64% for familial cancers.
Among the top 4 health age related issues polled, 38% of men stated they were concerned about cancer, 32% are concerned about their sexual health, and of that 32%, 44% of those men named erectile dysfunction as their top concern.
Cardiovascular disease and diabetes were diagnosed in 71% of those men polled who cited sexual dysfunction but erroneously believed erectile dysfunction was caused exclusively by low testosterone.
Encourage your patients to get their Annual Wellness Visit, regular check-ups and to normalize talking about urological and sexual health concerns. Early detection through preventive health screenings and checkups are essential to diagnosing many of these conditions while they are still in early treatable and curable stages.
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Tribal
Checking Member Eligibility
Did you know you can use the secure provider portal to check a member's eligibility for a specific Date of Service? We recommend that all patients have their eligibility checked prior to services being rendered on the MCO's portal to ensure the claims are being sent to the appropriate payer.
Why do we recommend regular eligibility checks? Below are just a few of the highlights:
- Claims submission to the correct payer will get you paid quicker and reduce eligibility denial work
- Medicaid members can change their MCOs monthly, and checking eligibility regularly supports accurate and up to date data
- With Medicaid Redeterminations initiated, checking eligibility will remain important to keep members enrolled in coverage where they qualify
If you would like 1:1 training on how to do this, please reach out directly to Carin Moritz at Carin.Moritz@coordinatedcarehealth.com
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Payment & Clinical Policy
Clinical Policy Updates
Monthly Updates
The below clinical policies received updates as part of our regular monthly review in June. These policy changes are effective July 1, 2023. You will find the policies, including a description of the revisions, posted on the policy site.
| Policy Number | Policy Title | Line of Business |
|---|---|---|
WA.CP.MP.130 | Fertility Preservation | Apple Health |
| CP.MP.58 | Intestinal and Multivisceral Transplant | Apple Health & Ambetter |
| CP.MP.244 | Liposuction of Lipedema | Apple Health & Ambetter |
| CP.MP.116 | Lysis of Epidural Lesions | Apple Health & Ambetter |
| WA.CP.MP.518 | Negative Pressure Wound Therapy for Home Use | Apple Health |
| CP.MP.176 | Outpatient Cardiac Rehabilitation | Ambetter |
| CP.MP.188 | Pediatric Oral Function Therapy | Apple Health & Ambetter |
| CP.MP.147 | Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention | Ambetter |
| CP.MP.210 | Repair of Nasal Valve Compromise | Apple Health & Ambetter |
| WA.CP.MP.509 | Upper GI Endoscopy for GERD | Apple Health |
The below policies were updated as part of our regular monthly review in June. The policy changes are effective October 1, 2023. You will find the policies, including a description of the revisions, posted on the policy site.
| Policy Number | Policy Title | Line of Business |
|---|---|---|
CP.MP.46 | Ventricular Assist Devices | Apple Health |
| CP.MP.182 | Short Inpatient Hospital Stay | Apple Health & Ambetter |
The below policy will be archived effective July 1, 2023.
| Policy Number | Policy Title | Line of Business |
|---|---|---|
CP.MP.128 | Optic Nerve Decompression Surgery | Apple Health & Ambetter |
The below genetic testing policies were previously announced as revised effective September 1, 2023. You will find the policies posted on the policy site. Most policy numbers have changed to V2.2023.
| Policy Number | Policy Title | Line of Business |
|---|---|---|
V2.2023 | CG Aortopathies and Connective Tissue Disorders | Apple Health & Ambetter |
| V2.2023 | CG Cardiac Disorders | Apple Health & Ambetter |
| V2.2023 | CG Dermatologic Conditions | Apple Health & Ambetter |
| V2.2023 | CG Epilepsy Neurodegenerative and Neuromuscular Conditions | Apple Health & Ambetter |
| V2.2023 | CG Exome and Genome Sequencing for DX of Genetic Disorders | Apple Health & Ambetter |
| V2.2023 | CG Eye Disorders | Apple Health & Ambetter |
| V2.2023 | CG Gastroenterologic Disorders Non-cancerous | Apple Health & Ambetter |
| V2.2023 | CG General Approach to Genetic Testing | Apple Health & Ambetter |
| V2.2023 | CG Hearing Loss | Apple Health & Ambetter |
| V2.2023 | CG Hematologic Conditions Non-cancerous | Apple Health & Ambetter |
| V2.2023 | CG Hereditary Cancer Susceptibility | Apple Health & Ambetter |
| V2.2023 | CG Immune Autoimmune and Rheumatoid Disorders | Apple Health & Ambetter |
| V2.2023 | CG Kidney Disorders | Apple Health & Ambetter |
| V2.2023 | CG Lung Disorders | Apple Health & Ambetter |
| V2.2023 | CG Metabolic Endocrine Mitochondrial Disorders | Apple Health & Ambetter |
| V2.2023 | CG Multisystem Inherited Disorders, Intellectual Disability and Developmental Delay | Ambetter |
| WA.CP.MP.230 | CG Multisystem Inherited Disorders, Intellectual Disability and Developmental Delay | Apple Health |
| V2.2023 | CG Non-Invasive Prenatal Screening | Ambetter |
| WA.CP.MP.231 | CG Non-Invasive Prenatal Screening | Apple Health |
| V2.2023 | CG Oncology Algorithmic Testing | Apple Health & Ambetter |
| V2.2023 | CG Oncology Cancer Screening | Apple Health & Ambetter |
| V2.2023 | CG Oncology Circulating Tumor DNA Tumor Cells Liquid Biopsy | Apple Health & Ambetter |
| V2.2023 | CG Oncology Cytogenetic Testing | Apple Health & Ambetter |
| V2.2023 | CG Oncology Molecular Analysis Solid Tumors & Hematologic Malignancies | Apple Health & Ambetter |
| V2.2023 | CG Pharmacogenetics | Apple Health & Ambetter |
| V2.2023 | CG Preimplantation Genetic Testing | Apple Health & Ambetter |
| V2.2023 | CG Prenatal and Preconception Carrier Screening | Apple Health & Ambetter |
| V2.2023 | CG Prenatal Diagnosis Pregnancy Loss | Apple Health & Ambetter |
| V2.2023 | CG Skeletal Dysplasia Rare Bone Disorders | Apple Health & Ambetter |
The below policies were previously announced as revised on the dates noted. You will find the policies posted on the policy site.
| Policy Number | Policy Title | Effective Date | Line of Business |
|---|---|---|---|
| CP.MP.100 | Allergy Testing and Therapy | 7/1/23 | Apple Health & Ambetter |
| CP.MP.108 | Allogenic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 7/1/23 | Apple Health & Ambetter |
| WA.CP.MP.37 | Bariatric Surgery | 7/1/23 | Apple Health |
| CP.MP.101 | Donor lymphocyte infusion | 7/1/23 | Apple Health & Ambetter |
| WA.CP.MP.36 | Experimental Technologies | 7/1/23 | Apple Health |
| CP.MP.36 | Experimental Technologies | 7/1/23 | Ambetter |
| CP.MP.40 | Gastric Electrical Stimulation | 7/1/23 | Apple Health & Ambetter |
| CP.MP.132 | Heart-Lung Transplant | 7/1/23 | Apple Health & Ambetter |
| CP.MP.86 | Neonatal Abstinence Syndrome Guidelines | 7/1/23 | Apple Health & Ambetter |
| CP.MP.102 | Pancreas Transplantation | 7/1/23 | Apple Health & Ambetter |
| CP.MP.120 | Pediatric Liver Transplant | 7/1/23 | Apple Health & Ambetter |
| CP.MP.162 | Tandem Transplant | 7/1/23 | Apple Health & Ambetter |
| CP.BH.201 | Deep Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder | 9/1/23 | Ambetter |
| CP.MP.146 | Sclerotherapy and Chemical Endovenous Ablation of Varicose Veins and Other Symptomatic Venous Disorders | 9/1/23 | Ambetter |
| CP.BH.200 | Transcranial Magnetic Stimulation for Treatment Resistant Major Depression | 9/1/23 | Apple Health & Ambetter |
| WA.CP.MP.522 | Varicose Vein Treatment | 9/1/23 | Apple Health |
Payment Policy Updates
We are committed to continuously evaluating and improving overall Payment Integrity solutions as required by State and Federal governing entities. We are therefore providing notification regarding changes to the below existing review criteria that will go into place on or after 10/1/2023.
| Description of Changes | Lines of Business |
|---|---|
| For the 72 Hour Rule criteria, diagnosis codes for the member’s outpatient and inpatient claims will no longer be matched and provider matching will be based on tax ID. These changes are in accordance with CMS guidelines and will apply to outpatient facility claims. | Medicare, Marketplace |
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Wellcare
REMINDERS
Medicare Prior Authorization - List effective 7/1/2023
Wellcare requires prior authorization (PA) as a condition of payment for many services. This notice contains information regarding such prior authorization requirements and is applicable to all Medicare products offered by Wellcare.
Wellcare is committed to delivering cost effective quality care to our members. This effort requires us to ensure that our members receive only treatment that is medically necessary according to current standards of practice. Prior authorization is a process initiated by the physician in which we verify the medical necessity of a treatment in advance using independent objective medical criteria and/or in network utilization, where applicable.
It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.
Please verify eligibility and benefits prior to rendering services for all members. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered. NON-PAR PROVIDERS & FACILITIES REQUIRE AUTHORIZATION FOR ALL HMO SERVICES EXCEPT WHERE INDICATED.
For complete CPT/HCPCS code listing, please see Online Prior Authorization Tool on our website.
Effective July 1st, 2023, the following are changes to prior authorization requirements:
| Service Category | PA Rule | Services | Procedure Codes |
|---|---|---|---|
Observation | No PA Required | Observation services | Rev code: 762 |
| Surgical procedures | No PA Required | Subcutaneous hormone pellet implantation | 11980 |
| Injectable medications | Step therapy | Injectables | J0587, J0588, J1437, J1439, J1443, J1444, J1445, J1449, J1460, J1560, Q0138, Q0139, Q5126, Q5127, Q5128, Q5129, Q5130 |
| Injectable medications | PA Required - No Step Therapy | Injection, onabotulinumotxinA, 1 unit | J0585 |
| Injectable medications | No PA Required | Injectables | J0897, J1750, J1756, J2916, Q0221 |
See as bulletin posting on Wellcare website
Part B Drug List Updates - Effective July 1, 2023
The following drugs require utilization review:
| Procedure | Description | Step Therapy |
|---|---|---|
J0585 | INJECTION, ONABOTULINUMOTXINA, 1 UNIT | |
| J0587 | INJECTION, RIMABOTULINUMTOXINB, 100 UNITS | STEP THERAPY |
| J0588 | INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT | STEP THERAPY |
| J1437 | INJECTION, FERRIC DERISOMALTOSE, 10 MG | STEP THERAPY |
| J1439 | INJECTION, FERRIC CARBOXYMALTOSE, 1 MG | STEP THERAPY |
| J1443 | INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC), 0.1 MG OF IRON | STEP THERAPY |
| J1444 | INJECTION, FERRIC PYROPHOSPHATE CITRATE POWDER, 0.1 MG OF IRON | STEP THERAPY |
| J1445 | INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC AVNU), 0.1 MG OF IRON | STEP THERAPY |
| J1449 | INJECTION, EFLAPEGRASTIM-XNST (ROLVEDON), 0.1 MG | STEP THERAPY |
| J1460 | INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC | STEP THERAPY |
| J1560 | INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC | STEP THERAPY |
| Q0138 | INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1MG (NON-ESRD USE) | STEP THERAPY |
| Q0139 | INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1MG (FOR ESRD ON DIALYSIS) | STEP THERAPY |
| Q5126 | INJECTION, BEVACIZUMAB-MALY, BIOSIMILAR, (ALYMSYS), 10 MG | STEP THERAPY |
| Q5127 | INJECTION, PEGFILGRASTIM-FPGK (STIMUFEND), BIOSIMILAR, 0.5 MG | STEP THERAPY |
| Q5128 | INJECTION, RANIBIZUMAB-EQRN (CIMERLI), BIOSIMIAR, 0.1 MG | STEP THERAPY |
| Q5129 | INJECTION, BEVACIZUMAB-ADCD (VEGZELMA), BIOSIMILAR, 10 MG | STEP THERAPY |
| Q5130 | INJECTION, PEGFILGRASTIM-PBBK (FYLNETRA), BIOSIMILAR, 0.5 MG | STEP THERAPY |
See as bulletin posting on Wellcare website.
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Apple Health Core Connections
AHCC Reunification Program – Supporting Parents
Parents who have children returning to their homes from foster care need trauma-minimizing support from health care providers. That may include starting to come to office visits to learn about how to keep their child healthy. We encourage providers to consider processes that let parents participate in their children’s health care (within HIPAA and clinic policy).
Coordinated Care’s Apple Health Core Connections team is working with Early Childhood Courts in Spokane, Clark, and Pierce Counties (and more to come) to help parents reunifying with their children get the information they need to work with health care providers and keep their kids healthy.
Background information on AHCC’s Reunification Program
What is HB 2530?
In 2018, the state passed legislation (HB 2530) for eligible children who were reunified with their parents to remain on AHCC for up to one year after dependency dismissal.
Who is Eligible?
In order to be eligible for continued AHCC coverage under HB 2530, the child must:
- Be under the age of eighteen
- Have been under the legal responsibility of the Department of Children, Youth and Families (DCYF) or a federally-recognized Indian tribe located within the state; and
- Meet eligibility standards for WA Apple Health aka Medicaid
Why should a family choose to enroll with AHCC following reunification?
- Keep child’s current medical and behavioral health providers
- Get information on past services and providers the child saw while in out-of-home placement
- Have peace of mind by having a health care coordination team that is trained to understand the challenges unique to children and their families who have received services from child welfare
- A personal advocate and health coach to help the parent understand the health care needs of their child
- Connections to community resources and support
- Help finding providers, scheduling appointments, and navigating the health care system
- Support for accommodation requests in schools
- Extra programs and support so parents can ensure their child is thriving
- Access health education to support understanding of health conditions, such as diabetes, asthma, depression, anxiety, autism, childhood obesity, etc.
How long can a child stay with AHCC after reunification?
Children continue enrollment under AHCC with no interruption during a trial return home as long as their dependency remains open. A child is eligible for up to 12 months of continued coverage from the date the dependency is dismissed.
Coordinated Care is the single managed care organization to administer the Integrated Managed Care Apple Health Foster Care program in collaboration with the Health Care Authority and Department of Children Youth and Families. This program serves children and youth in foster care, adoption support, alumni of foster care (ages 18-26), and children reunified with their parents. Coordinated Care’s program is named “Apple Health Core Connections.” You can reach our Care Coordination team at 1-844-354-9876 or AHCCTeam@coordinatedcarehealth.com.
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Training/Education
Health equity series, session 1: Prevention leadership through a culturally humble lens. This first session of our Health Equity Series 2023 is an interactive course that will provide a foundational conversation placing the idea of prevention leadership in the context of cultural humility, inequity, and social justice. July 19, 2023, 9:00am to 10:30am Register Here.
Addressing a co-occurring epidemic: substance misuse and suicide. Suicide is one of the leading causes of death in the United States across all age groups. In this session, we will analyze this co-occurring epidemic. Participants will learn how to navigate and overcome the barriers that have impacted professionals in the suicide and substance use prevention field from working together to solve this problem in the past. July 27, 2023, 11:30am to 1:00pm Register Here.
Continuing the conversation about ACEs: ACE talk with family and friends workshop. Do you find it difficult to talk with families and communities about the adverse childhood experiences (ACEs) study and its relationship with substance misuse? If so, you are not alone. Beginning with highlighting awareness of toxic stress and its impact on child development, this workshop will use a strengths-based approach and a trauma-informed lens to focus on positive childhood experiences, as well as building resilience. July 13, 2023, 9:30am to 11:00am Register Here.