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2017 ForwardHealth Updates

ForwardHealth Updates — 2017

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Update NumberForwardHealth Update Topic(s) and release date
2017-44 Prior Authorization No Longer Required for Evaluations or Re-Evaluations for Occupational Therapy, Physical Therapy, and Speech-Language Pathology, 12/21/17
2017-43 National Coordination of Benefits Agreement Medicare Part A and Medicare Part B Crossover Claims Process, 12/21/17
2017-42 January 2018 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/15/17
2017-41 Increased Reimbursement and Changes to Claims Submission Requirements for Outpatient Behavioral Health Services, 12/13/17

January 26th, 2018: This ForwardHealth Update has been revised since its original publication. Providers should refer to the maximum allowable fee schedule for the correct rates. Several rates published in the attachments of this Update were recently revised. ForwardHealth will be publishing another Update soon with current information.
2017-40 Family Care, Partnership, and IRIS Expand in Dane County, 12/7/17
2017-39 Expanded List of Allowable Vaccines for Pharmacy Providers, 12/4/17
2017-38 Hospital Access Payments Discontinued for Fiscal Year 2017, 11/30/17
2017-37 Clarification of Claim Submission Requirements for Outpatient Hospital Services, 11/2/17
2017-36 ForwardHealth Holiday Schedule, 11/2/17
2017-35 Hospice Reimbursement Rate Changes, 10/31/17

November 29, 2017: This Update has been revised since its original publication. The note in the Attachment has been revised to clarify the addresses on which the procedure and revenue codes are based.
2017-34 New and Clarified Pharmacy Policy and Claims Submission Requirements, 10/26/17
2017-33 Ambulatory Surgical Center Access Payments Permanently Discontinued, 10/12/17
2017-32 Prior Authorization Required for Mavyret™ and Vosevi™, 10/6/17
2017-31 Nursing Home Level of Care Process Change and New Level of Care Report, 10/6/17
2017-30 Revised Hearing Aid Contract Models and Pricing Effective September 2017, 9/28/17

October 11, 2017: This Update has been revised since its original publication. Pricing information for one Unitron Hearing half-shell hearing aid model (Stride 700-Binaural) has been revised and an additional model designation has been added for one Phonak Hearing Systems hearing aid model (Sky V50). Revisions on pages 9 and 11 of Attachment 2 are indicated in red.
2017-29 New Billing Instructions for Claims with Deductible, Coinsurance, Copayment, Blood Deduction, or Psychiatric Reduction, 9/8/17
2017-28 Changes to Coverage Policy and Prior Authorization Requirements for Behavioral Treatment, 9/5/17
2017-27 New Prior Authorization Policy for Outpatient Behavioral Health Services, 9/5/17
2017-26 New Policy and Procedure Codes for Certain Dental Services and Appliances 8/25/17
2017-25 New and Clarified Telehealth Policy, 8/18/17
2017-24 Cancellation of the Personal Care Independent Assessment Program, 7/31/17
2017-23 Ambulatory Surgical Center Access Payments Discontinued for Fiscal Year 2017, 7/13/17
2017-22 Clarifications to BadgerCare Plus and Medicaid SSI Managed Care Provider Appeal Policy, 7/5/17
2017-21 Changes to Billing Policy for Serial Casting for Therapy Providers, 6/29/17
2017-20 Family Care and IRIS Expansion, 6/27/17
2017-19 Information for Eligible Professionals Regarding Program Year 2017 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/19/17

October 2, 2017: Information under the "Clinical Quality Measure Reporting Periods" heading has been revised in response to the Hospital Inpatient Prospective Payment System final rule. The change is indicated in red text.
2017-18 Information for Eligible Hospitals Regarding Program Year 2017 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/19/17

October 2, 2017: Information under the "Clinical Quality Measure Reporting Periods" heading has been revised in response to the Hospital Inpatient Prospective Payment System final rule. The change is indicated in red text.
2017-17 July 2017 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/16/17

June 21, 2017: This Update has been revised with additional information since its original publication. Information under Olysio® as Combined with Sovaldi® has been added in red text on page 17 of the Update.
2017-16 Prior Authorization Required for Spinraza™, 5/24/17
2017-15 Changes to Reporting Other Coverage Discrepancies for Commercial Insurance and Medicare Coverage, 5/12/17
2017-14 Fee–for–Service Hospital Withhold Pay for Performance Program Discontinued, 5/8/17
2017-13 New Coverage Policy for Digitized Speech Generating Devices, 5/4/17
2017-12 Coverage of Residential Substance Abuse Treatment by Comprehensive Community Services Providers, 5/3/17
2017-11 New Personal Care Independent Assessment and Prior Authorization Policy, 4/6/17

July 31, 2017: The independent assessment and prior authorization policy outlined in this ForwardHealth Update is obsolete as of August 1, 2017. Please refer to the July 2017 Update (2017-24), titled "Cancellation of the Personal Care Independent Assessment Program," for more information or to the ForwardHealth Online Handbook for current personal care policy.
2017-10 Changes to Billing Policy for Family Planning Clinics, 3/29/17
2017-09 Nursing Homes Required to Submit New Notification of Death Form to the Estate Recovery Program, 3/27/17
2017-08 Regional Provider Trainings for New Personal Care Independent Assessments and Prior Authorization Process, 3/20/17

March 22, 2017: This Update has been revised since its original publication. Home Health Agencies was added to the "To" provider list.
2017-07 Changes to Billing and Reimbursement Policy for Covered Outpatient Drugs, 3/15/17
2017-06 Coverage Policy for Facial Prosthetics, 3/1/17
2017-05 Policy Changes for Clinics and Independent Providers for Mental Health Services Provided in a School, 3/1/17
2017-04 New Policy Regarding Developmentally Disabled Level of Care Assignments, 2/14/17
2017-03 Changes to Commercial Insurance Billing Requirements for Intensive In-Home Mental Health and Substance Abuse Treatment Services, 1/25/17
2017-02 New Coverage Policy for Home Ventilator Rental, 1/26/17
2017-01 2017 CPT and HCPCS Procedure Code Changes, 1/9/17
 
 
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