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.
We will communicate Information about changes related to our partnership with Medica through monthly policy notices, quarterly newsletters and other communications when needed. You'll find all of these linked from this web page.
2023 member plan and benefit highlights for provider awareness.
Issued: November 2022
Audience: All in-network providers
Effective date: 1/1/22
See 2023 changes (PDF)
We are transitioning the claim appeals application in the Provider Portal.
Issued: August 2022
Audience: All in-network providers
Effective date: 8/24/22
See new claims application (PDF)
Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/22
See 2022 changes (PDF)
ACA Individual Plans and Prevea360 Medicare Advantage Plans are available in Chippewa and Eau Claire counties.
Issued: October 2021
Audience: In-network providers in Chippewa and Eau Claire counties
Effective date: 1/1/22
See expansion details (PDF)
FDA approved drugs that are new to the market will not be covered until they are reviewed and approved by P&T Committee.
Issued: September 2021
Audience: All in-network providers
Effective date: 12/1/21
See P&T Committee change (PDF)
Issued: August 2021
Audience: All providers
Effective date: N/A
See provider announcement (PDF)
Issued: August 2021
Audience: In-network prescribers
Effective date: 10/1/2021 & 1/1/22
See new vicosupplement policy (PDF)
Issued: July 2021
Audience: All in-network providers
Effective date: 7/22/21
See website info (PDF)
Issued: July 2021
Audience: All in-network providers
See preventive care/screening info (PDF)
Issued: June 1, 2021
Effective date: 9/1/21
See new ID cards (PDF)
Changes to the prior authorization process for inpatient and outpatient total knee arthroplasty and total hip arthroplasty procedures.
Issued: April 2021
Audience: Orthopedists and orthopedic surgeons
Effective date: 7/1/21
See knee & hip arthroplasty changes (PDF)
Annual notification with member-centered plan and benefit topics for provider awareness for 2021.
Issued: October 2020
Audience: All in-network providers
Effective date: 1/1/21
See 2021 plan & benefits changes (PDF)
Audience: all in-network providers
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)
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: 6/1/22
Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies (PDF)
Issued: February 2022
Effective date: 5/1/22