Provider communications

Provider information

We release communications to in-network providers about changes to health plan procedures, policies and benefits, as well as information about larger initiatives. This page lists some of our issued notifications for reference.

Our Medica partnership

Access information about our evolving partnership with Medica, an independent, nonprofit health plan headquartered in Minnetonka, Minnesota, and how we are using this partnership to strengthen our ability to provide high quality support for providers and members.

• Medica Advantage Quick Reference – for providers contracted to deliver care to Medica Advantage (formerly WellFirst Health) members in Illinois and Missouri for plan year 2024. 
• Medica (formerly WellFirst Health) Provider Quick Reference by Payer ID – identifies resources and processes with the addition of payer ID 41822.

Provider Authorization Submission Update

Upcoming changes & enhancements to the prior authorization experience with our health plan
Issued: August 14, 2024
Audience: All in-network providers

See August 14 provider communication (PDF)

Change Healthcare cybersecurity incident update

Our planned mitigation to the security incident.
Issued: March 26, 2024
Audience: All in-network providers

See March 26 provider communication (PDF)
Updated FAQ for providers (PDF)

Services through Change Healthcare with any payer are not operating at this time.

Issued: March 8, 2024
Audience: All in-network providers

See March 8 provider communication (PDF)

Plan and benefits changes for 2024

2024 member plan and benefit highlights for provider awareness.
Issued: December 2023
Audience: All in-network providers
Effective date: 1/1/24

See 2024 changes (PDF)

Plan and benefits changes for 2023

2023 member plan and benefit highlights for provider awareness.
Issued: November 2022
Audience: All in-network providers
Effective date: 1/1/23

See 2023 changes (PDF)

Medical and drug policy updates

Starting November 1, 2023, policy notices are published in our monthly newsletters. 

Audience: all in-network providers

• Notice dated: October 1, 2023 (PDF)
• Notice dated: September 1, 2023 (PDF)
• Notice dated: August 1, 2023 (PDF)
• Notice dated: July 1, 2023 (PDF)
• Notice dated: June 1, 2023 (PDF)
• Notice dated: April 28, 2023 (PDF)
• Notice dated: March 31, 2023 (PDF)
• Notice dated: March 1, 2023 (PDF)
• Notice dated: Feb. 1, 2023 (PDF)
• Notice dated: Dec. 30, 2022 (PDF): Features new medical policies for oncology genetic testing and transplantation.
• Notice dated: Dec. 1, 2022 (PDF): Features rare diseases and system specialty specific new genetic testing medical policies.
• Notice dated: Nov. 1, 2022 (PDF): Features prenatal new genetic testing medical policies, updated clinical guidelines for imaging and MSK, oncology program reminders and ACA medical record reviews. 
• Notice dated: Sept. 30, 2022 (PDF)
• Notice dated: Sept. 1, 2022 (PDF)
• Notice dated: Aug. 1, 2022 (PDF)
• Notice dated: July 1, 2022 (PDF)
• Notice dated: June 1, 2022 (PDF)
• Notice dated: April 29, 2022 (PDF)
• Notice dated: April 1, 2022 (PDF)

Pharmacy material change notices

For pharmacy updates issued on and after April 1, 2022, see the medical and drug policy updates listed on this page.

Audience: All in-network providers 

ALDURAZYME-laronidase, ARANESP-darbepoetin alpha, ELAPRASE-idursulfase, ELELYSO-taliglucerase alfa, Epoetin Alfa Products, NAGLAZYME-galsulfase, VIMIZIM-elosulfase, and retired policy (PDF)
Issued: February 2022
Effective date: 6/1/2022

Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies (PDF)
Issued: February 2022
Effective date: 5/1/2022