News and Updates

• Blue Review Newsletter
  

• 7/03/25 Review Changes to National Drug Code Fee Schedule
• 7/02/25 Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 2
• 7/01/25 Update: We’re Updating Our Payment Systems to Help Improve Efficiencies
• 6/30/25 Prior Authorization Changes for Medicare Advantage and Healthy Montana Kids, Effective Oct. 1, 2025
• 6/27/25 Prior Authorization Codes Updated for Commercial Members, Effective Oct. 1, 2025
• 6/24/25 New Coding Policy for Global Obstetrical Maternity Services
• 6/24/25 Watch for Our Provider Availability and Access Survey
• 6/23/25 Review Updates to Clinical Practice and Preventive Care Guidelines
• 6/20/25 ClaimsXten^TM Code Update Effective Aug. 18, 2025  
• 6/18/25 Encourage Medicare Members to Respond to Health Outcomes Survey
• 6/17/25 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
• 6/10/25 Member Rights and Responsibilities
• 6/10/25 Provider Rights and Responsibilities
• 6/03/25 Use Simplified Referral Form for American Indian/Alaska Native Limited Cost Share Plans
• 6/02/25 Encourage Routine Vaccines and Well-Care Visits for Adolescents
• 5/30/25 Postponed: Enhanced Claim Edit for Oncology Drugs and Services for Medicare Members
• 5/29/25 Providers with Unused Record IDs May be Terminated from Networks
• 5/28/25 Prior Authorization Code Changes for Commercial Members, Effective July 1, 2025 
• 5/28/25 Verify Your Directory Information Every 90 Days
• 5/27/25 Clinical Payment and Coding Policy Updates
• 5/23/25 Update: Behavioral Health Substance Use Criteria for Utilization Management
• 5/22/25 Claims Reminders for Behavioral Health Services
• 5/20/25 Update: New Home Delivery Pharmacy Service to Fill Members’ Injectable GLP-1 Prescriptions
• 5/13/25 Quality Measures Track Diabetes Care
• 5/09/25 Update: Access BlueApprovR^SM in Availity^® Authorizations, Effective in June 2025
• 5/06/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 2
• 4/24/25 Your NICU Claims Submissions Should Match Prior Authorization Levels of Care Effective Aug. 1, 2025
• 4/23/25 Payment Error Rate Measurement Program Identifies Common Medicaid Claims Errors
• 4/09/25 Reinforce Prenatal and Postpartum Care to Support Whole Health
• 4/03/25 Prior Authorization Changes for Medicare Advantage and Healthy Montana Kids, Effective July 1, 2025
• 4/03/25 Prior Authorization Changes for Some Commercial Members, Effective July 1, 2025
• 4/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 2
• 3/27/25 Coding and Compensation Policy Updates
• 3/26/25 Clinical Series Program Offers Education on Pediatric Care
• 3/19/25 Cigna Healthcare Medicare Advantage Transaction Complete
• 3/17/25 Watch for Our Annual Satisfaction Survey
• 3/14/25 Update Your Records with New Member ID Numbers
• 3/13/25 Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
• 3/05/25 Earn Continuing Education Credit in Webinar on Behavioral Health in Older Adults
• 2/26/25 We’re Updating Our Payment Systems to Help Improve Efficiencies 
• 2/25/25 Coding and Compensation Policy Updates
• 2/14/25 Claims Review to Be Enhanced for Oncology Drugs and Services for Medicare Members, Effective June 1, 2025
• 2/14/25 Education and Residency Information Required for Directory
• 2/14/25 Encourage Follow-up Care after Hospital Visits for Mental Health
• 2/12/25 Has Your Information Changed? Update Us and the NPI Registry
• 2/07/25 Itemized Bills or Medical Records May Be Required for Additional Facility Claims
• 2/07/25 Utilization Management Review Paused for Advanced Imaging Site of Care
• 2/05/25 Discuss Colon Health and Preventive Screening with Our Members
• 2/04/25 Earn Continuing Education Credit with Courses on Tobacco Cessation
• 2/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 1
• 1/24/25 Encourage Medicare Advantage Members to Respond to Survey on Health Care Experiences
• 1/24/25 Update: Medical Policy Updates for Self-Administered Drugs Effective April 15, 2025
• 1/23/25 March of Dimes^® Courses on Maternal Mental Health Offer Continuing Education Credit at No Cost 
• 1/23/25 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
• 1/22/25 Hospitals Must Provide Notice to Members Under Outpatient Observation for More Than 24 Hours 
• 1/15/25 Avoid the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
• 1/15/25 Confirm Your Medical Records Align with Submitted Claims
• 1/13/25 Big Sky Pulmonary Conference Set for March 6-7, 2025
• 1/10/25 Quality Measures Help Track Our Members’ Heart Health
• 1/10/25 Laboratory Management Payment and Coding Policies Updated
• 1/09/25 Reduce Barriers to Care for Indigenous Montanans
• 1/07/25 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2025 – Part 2

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