Medicare Prior Authorization Changes Effective October 1, 2023

09/01/23

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 - Annual Special Needs Plan Model of Care Training

08/28/23

The Centers for Medicare & Medicaid Services (CMS) requires health plans to provide annual education and training on Wellcare’s Model of Care to providers who treat our Special Needs Plan (SNP) members.

Medicare Prior Authorization Changes - 10/1/2023

08/17/23

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.

Congenital Syphilis a Public Health Concern! New MSDH Prenatal Syphilis Testing Requirements

06/08/23

Congenital syphilis is a public health concern in Mississippi! After a more than 1100% rise in congenital syphilis cases from 2019 (3 cases) to 2020 (37 cases), the trend continued in 2021 with another sharp increase to 64 reported congenital syphilis cases in Mississippi. This led to a 2021 rate of 182 cases per 100,000 live births, ranking 4th highest overall in the US.

Wellcare by Allwell - Termination of Somatus Care Management Program for Patients with CKD/ESRD

06/01/23

Effective July 1, 2023, we will no longer partner with Somatus Inc., which provides care management services for members with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Some of your patients may be affected by this change.

Medicare Prior Authorization

05/16/23

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.

Medicare Member Plan Benefits Resume for Applicable COVID-19 Testing, Screening, and Treatment Services on May 12, 2023

05/12/23

Earlier this year, the Biden Administration announced that the federal Public Health Emergency (PHE) related to the COVID-19 pandemic will end on May 11, 2023.

*MEDICAID/ NIA PRIOR AUTHORIZATION REQUIREMENTS - EFFECTIVE 7/1/2023*

05/02/23

National Imaging Associates, Inc. (NIA) provides utilization management for non-emergent Medical Specialty Solutions for Magnolia Health members. Magnolia Health has expanded its partnership with NIA to streamline authorization processes and improve member outcomes. As a result, effective July 1, 2023, NIA will expand the prior authorization program to include the following types of non-emergent outpatient Medical Specialty Solution services:

*WELLCARE / NIA PRIOR AUTHORIZATION REQUIREMENTS - EFFECTIVE 7/1/2023*

04/21/23

In addition to the procedures that currently require prior authorization through NIA, certain cardiac-related procedures will also require prior authorization beginning July 1, 2023. Providers may begin contacting NIA on July 1, 2023, to seek prior authorization for procedures scheduled on or after July 1, 2023.

How to Help Medicaid Members Update Their Information

03/17/23

Coverage Champions, providers, and community organizations wishing to partner with individuals and families covered by Mississippi Medicaid who may need to update their contact information can help in two ways.