What types of policy changes does CareSource issue?

CareSource regularly publishes coverage updates including prior authorization requirement changes, billing code additions or deletions, plan-type coverage modifications, and clinical policy revisions. PolicyChanges.app monitors these notices and summarizes the impact for providers.

How often does CareSource update its policies?

CareSource typically releases policy bulletins on a rolling basis throughout the year. Our system checks for new updates daily and adds them to this feed as soon as they are identified.

How many CareSource policy changes are tracked here?

This page currently tracks 50 documented CareSource policy changes. New items are added as they are identified.

What should I do when CareSource changes a prior authorization policy?

Review each change's effective date and action-required notes. Update your billing and clinical workflows before the effective date to avoid claim denials. Each policy detail page on PolicyChanges.app includes a plain-English summary and action items.

PAYER POLICY CHANGES

CareSource Policy Changes & Prior Auth Updates

We track 50 documented policy changes from CareSource across GA, IN, KY, NC, NV and 3 more states. Each entry includes an AI-generated plain-English summary, effective date, affected billing codes, and a direct link to the original CareSource notice. Use the related links below to narrow results by specialty or state, or create a free alert to get new CareSource updates by email (daily or weekly, your choice, on every plan).

CareSource · Effective Dec 1, 2026High impact
[Ohio] Avalon Policy Updates
CareSource Ohio Medicaid has partnered with Avalon Healthcare Solutions for laboratory benefits management and is revising 36 laboratory reimbursement policies effective December 1, 2026. These revised policies govern routine lab testing through Avalon's post-service pre-payment clinical claim editing program (RTM). No prior authorization requirement changes are indicated, but billing teams must ensure compliance with updated lab policies on Avalon's website to avoid claim denials.
CareSource · Effective Dec 1, 2026High impact
[Indiana] Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint
Effective December 1, 2026, CareSource is expanding TurningPoint's Cardiac and Musculoskeletal Surgical Quality and Safety Management Program to Indiana Medicaid members (Healthy Indiana Plan and Hoosier Healthwise). Prior authorization is now REQUIRED for all cardiac surgeries and musculoskeletal/orthopedic procedures listed in the policy before service delivery. Claims without prior authorization will be denied.
CareSource · Effective Dec 4, 2026High impact
[Georgia] Claims Editing Enhancements
CareSource Georgia Medicaid will implement enhanced claims editing effective December 4, 2026, adding new validation rules for modifier usage, E/M code bundling, lab tests, surgical pathology units, and DME replacement history. Claims that fail these edits will be denied.
CareSource · Effective Jan 1, 2027High impact
[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers
Starting January 1, 2027, all Ohio Medicaid claims must include the Ordering, Referring, or Prescribing (ORP) provider's NPI number or they will be denied. This affects numerous services including DME, imaging, lab work, therapies, consultations, and institutional claims.
CareSource · Effective Dec 1, 2026Medium impact
[Georgia] Administrative/Medical Policy Update (1/2)
CareSource Georgia is releasing two policy updates effective December 1, 2026: a revision to the Cystic Fibrosis Testing administrative policy (AD-0842) and a new medical policy for Vein Embolization for Treatment of Pelvic Pain (MM-1844). The billing team must review both policies on the CareSource website to understand specific coverage, coding, and prior authorization requirements before the effective date.
CareSource · Effective Dec 1, 2026Medium impact
[Indiana] October 2026 Policy Updates
CareSource Indiana Medicaid is releasing 13 policy updates effective December 1, 2026, spanning medical, administrative, and reimbursement categories. Changes include new policies for Speech Generating Devices, Newborn/NICU Level of Care, EKG Interpretations, and Postpayment Review procedures, along with revisions to existing policies covering clinical trials, pain management, behavioral health documentation, coding guidelines, and claims editing. None of these changes impact prior authorization requirements.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] Administrative/Medical Policy Update (2/2)
CareSource Georgia Medicaid is revising two medical policies (Epidural Steroid Injection MM-0217 and Intraosseous Basivertebral Nerve Ablation MM-1303) and releasing a new administrative policy on Prior Authorization Submission for Providers (AD-1646), all effective January 1, 2027. The billing team must review the full revised policies online to identify specific coverage, coding, or prior authorization requirement changes and update workflows accordingly.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] Medical Policy Update
CareSource Georgia Medicaid is revising three medical policies effective January 1, 2027 and December 1, 2026. The notice lists policy updates but does not specify what changed within each policy. To understand billing and authorization requirements, your practice must access the full revised policies on CareSource.com.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] November 2026 Pharmacy Policy Updates (1/3)
CareSource Georgia Medicaid is introducing new pharmacy policies for seven drugs (adalimumab, brensocatib, donidalorsen, elamipretide, nerandomilast, imadenovec-drba, and remibrutinib) effective January 1, 2027. The notification does not specify coverage criteria, prior authorization requirements, or billing codes; the practice must access the full policies on CareSource's website to determine billing and authorization workflows for these new medications.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] November 2026 Pharmacy Policy Updates (1/3)
CareSource Georgia Medicaid is establishing seven new pharmacy policies effective January 1, 2027, covering branded and generic medications including adalimumab (Humira and biosimilars), brensocatib, donidalorsen, elamipretide, nerandomilast, imadenovec-drba, and remibrutinib. Billing teams must verify coverage criteria, prior authorization requirements, and formulary status for these drugs before claims submission on or after the effective date.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] November 2026 Pharmacy Policy Updates
CareSource Georgia Medicaid is implementing seven new pharmacy policies effective January 1, 2027, covering medications including Adalimumab (Humira and biosimilars), Brinsupri, Dawnzera, Forzinity, Jascayd, Papzimeos, and Rhapsido. The billing team must prepare to apply these new policies to claims submitted on or after the effective date.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] November 2026 Pharmacy Policy Updates (2/3)
CareSource Georgia Medicaid is revising its pharmacy policy for Immune Globulin (IVIG and SCIG) effective January 1, 2027. The source document provides notice of this policy revision but does not specify what aspects of coverage, prior authorization, dosing, or reimbursement have changed. Billing teams must obtain and review the full revised policy before the effective date to determine workflow impacts.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] November 2026 Pharmacy Policy Updates (3/3)
CareSource Georgia Medicaid is revising pharmacy policies for 58 medications and drug classes effective January 1, 2027. The updates include revised coverage policies for existing medications (e.g., Aflibercept, Enbrel, Imbruvica), addition of three new medications (Exdensur, Hepcludex, Icotyde, Lynavoy, Waskyra), and an annual review of Pyrukynd. None of these policy changes impact prior authorization requirements.
CareSource · Effective Jan 1, 2027Medium impact
[Indiana] November 2026 Policy Updates
CareSource Indiana Medicaid is introducing a new medical policy for Applied Behavior Analysis (ABA) for Autism Spectrum Disorder (Policy MM-1869) effective January 1, 2027. This new policy does not impact prior authorization requirements. Billing teams should review the full policy details on CareSource's provider portal to understand coverage criteria and any documentation requirements for ABA services.
CareSource · Effective Jan 1, 2027Medium impact
[Indiana] November 2026 Pharmacy Policy Updates
CareSource Indiana Medicaid released 21 pharmacy policy updates effective January 1, 2027, affecting specialized medications across multiple therapeutic categories (rare diseases, ophthalmology, pulmonology, hematology, and others). The updates include 14 revised policies, 3 new policies, 1 annual review, and 1 archived policy. None of the changes impact prior authorization requirements.
CareSource · Effective Jan 1, 2027Medium impact
[Ohio] November 2026 Policy Updates
CareSource Ohio Medicaid is revising eight administrative and medical policies and introducing one new reimbursement policy, all effective January 1, 2027. Changes affect esophageal brush biopsy, experimental/investigational services, gender dysphoria treatment, obstetrical care, retrospective authorization review, hospice billing, diabetes self-management training, neonatal discharge criteria, and obstetrical care reimbursement. None of these revisions impact prior authorization requirements.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] Administrative Policy Update (1/2)
CareSource Georgia is revising administrative policy AD-0084 regarding Electronic Data Interchange and Transactions, effective January 1, 2027. The full policy details are not provided in this notification document, only the policy title, number, and effective date are listed.
CareSource · Effective Jan 1, 2027Medium impact
[Georgia] Administrative Policy Update (2/2)
CareSource Georgia Medicaid is updating its Obstetrical Ultrasounds administrative policy (AD-1636) effective January 1, 2027. The notification announces this policy change but does not provide details of the specific content changes in the excerpt provided. The billing team must obtain the full policy document to identify what administrative requirements or workflows have been revised.
CareSource · Effective Feb 1, 2027Medium impact
[Ohio] November 2026 Pharmacy Policy Updates
CareSource Ohio Medicaid released revised pharmacy policies for 12 specialty medications effective February 1, 2027. All revised policies explicitly state 'NO' impact to prior authorization requirements, meaning current PA workflows remain unchanged for these drugs. The policy document serves as notification of policy revisions; billing teams should review the full policies online to identify any other coverage or documentation changes not summarized in this notice.
CareSource · Effective Dec 1, 2026Low impact
[Georgia] October 2026 Administrative Policy Updates
CareSource Georgia Medicaid has issued a network notification for October 2026 policy updates. One revised administrative policy (Court Mandated Health Services, AD-0805) becomes effective December 1, 2026. The notification establishes a predictable monthly cycle for policy releases and directs providers to access full policy details through CareSource's online provider portal.
CareSource · Effective Dec 1, 2026Low impact
[Georgia] October 2026 Pharmacy Policy Updates
CareSource Georgia Medicaid has revised the pharmacy policy for Lyfgenia (lovotibeglogene autotemcel), effective December 1, 2026. This is a revised policy with no changes to prior authorization requirements, indicating the drug's coverage terms or clinical guidelines have been updated. Billing teams should review the full policy details to ensure accurate claims processing.
CareSource · Effective Dec 1, 2026Low impact
[Indiana] October 2026 Pharmacy Policy Update
CareSource Indiana Medicaid has issued a revised pharmacy policy (IN-MED-P-5901950-V.1) effective December 1, 2026, regarding Medical Benefit Medications. The policy revision does not introduce new prior authorization requirements. This is a routine policy update maintaining CareSource's monthly cycle for consolidated pharmacy policy notifications.
CareSource · Effective Nov 1, 2026High impact
[Indiana] September 2026 Pharmacy Policy Updates
CareSource Indiana Medicaid is updating 16 specialty pharmacy policies effective November 1, 2026. Changes include 4 new policies (Aqvesme, Avlayah, Loargys, and others), 7 revised policies with updated coverage criteria, 4 annual reviews with no clinical updates, and 1 archived policy (Mycapssa). Billing teams must review each policy's specific prior authorization, coverage limits, and documentation requirements before the effective date.
CareSource · Effective Nov 1, 2026High impact
[Indiana] Important Notice about Part D Drug Coverage
Effective November 1, 2026, CareSource will no longer reimburse for Medicare Part D drugs for Indiana Medicaid members who have both Medicare and Medicaid or who have opted out of Medicare Part D. Affected members will now be responsible for Medicare cost shares or copays instead of having these costs covered through their Medicaid benefit.
CareSource · Effective Oct 1, 2026High impact
[Georgia] September 2026 Pharmacy Policy Updates
CareSource Georgia Medicaid has updated pharmacy policies for 31 medications effective October 1, 2026. The notification lists policy changes across rare disease treatments, biologics, and specialty pharmaceuticals—including 4 new policies, 20 revised policies, and 7 annual reviews with no changes. Your billing team must review each affected medication's specific policy requirements (prior authorization, clinical criteria, dosing limits) on the CareSource provider portal to ensure compliant claim submission.
CareSource · Effective Oct 1, 2026High impact
[Ohio] September 2026 Policy Updates
CareSource Ohio Medicaid is releasing 9 policy updates effective October 1 and November 1, 2026, spanning administrative, medical, and reimbursement categories. Key changes include a new prior authorization submission requirement (AD-1645), revisions to E/M visit billing when preventive and acute care occur same-day (PY-0007), updates to durable medical equipment repairs coverage (MM-1579), and changes to anesthesia care reimbursement (PY-1685). The billing team must review each policy in detail and implement system and workflow changes before the effective dates.
CareSource · Effective Oct 1, 2026High impact
[Ohio] Collecting Additional Information for Laboratory Services
CareSource is implementing enhanced documentation requirements for all laboratory services under Ohio Medicaid and Ohio MyCare plans, effective October 1, 2026. Ordering providers must maintain and submit medical necessity documentation within 45 days of MCO requests, or face claim denials and potential recoupment. This applies to both pre-adjudication and post-payment claim reviews.
CareSource · Effective Oct 1, 2026High impact
[Ohio] August 2026 Policy Updates
CareSource Ohio Medicaid released 10 policy updates effective October 1, 2026 and November 1, 2026, including 3 new policies (Pediatric Medical Strollers, Postpayment Review Non-Submission of Medical Records, Telehealth and Place of Service for Community Mental Health Clinics, and Urgent Care Facilities) and 6 revised policies affecting home mechanical ventilation, endoscopic procedures, substance use disorder treatment, TENS units, penile implants, and administrative processes. Billing teams must review each policy's full text to understand specific coverage, documentation, and reimbursement changes before the October and November effective dates.
CareSource · Effective Sep 3, 2026High impact
[Ohio] Submission Requirements for Uniform Itemized Bills
CareSource (Ohio Medicaid, Marketplace, and MyCare Ohio) has established new submission requirements for itemized bills effective immediately. All itemized bills must be submitted in text-only format with specific structural requirements including MM/DD/YYYY date format, required header fields (Date, Revenue Code, CPT Code, Description, Quantity, Charges), and reconcilable charges at claim and revenue code levels. Noncompliance may result in processing delays, requests for corrected documentation, or claim denial.
CareSource · Effective Sep 1, 2026High impact
[Ohio] Billing Guidance
CareSource Ohio Medicaid issued comprehensive billing guidance effective September 1, 2026, clarifying six key compliance areas: laboratory services in hospital settings cannot be separately billed, fluoride varnish is limited to 2 applications/year for children under 21, physician interpretation-only codes must not include technical components, GZ modifier usage requires ABN documentation, add-on procedure codes require primary procedure codes, and inpatient ICD-10 codes must specify laterality (right/left/bilateral) rather than using unspecified codes. Providers must immediately review billing practices to avoid claim denials and potential recovery of payments found non-compliant with OAC and CMS rules.
CareSource · Effective Sep 1, 2026High impact
[Ohio] Evaluation and Management (E/M) and Psychotherapy Add-On Billing Policy
CareSource Ohio Medicaid is implementing strict concurrent billing restrictions on psychotherapy add-on codes (90833, 90836, 90838) with high-level E/M services (99204, 99205, 99214, 99215). When billed together on the same date by the same provider, psychotherapy add-ons will be denied and only the E/M will be reimbursed. Providers must now document separate start/stop times, non-overlapping clinical effort, and ensure E/M levels are based on medical decision-making rather than time when billing these combinations.
CareSource · Effective Sep 1, 2026High impact
[Ohio] Behavioral Health Time-based Service Documentation Requirement
CareSource Ohio Medicaid is changing behavioral health time-based service documentation requirements. Effective September 1, 2026, providers must document start and stop times for all behavioral health services; documentation showing only total time will no longer be accepted. Claims for dates of service on or after September 1, 2026 that lack start and stop times will be denied after medical record review.
CareSource · Effective Sep 1, 2026High impact
[Indiana] July 2026 Policy Updates
CareSource Indiana Medicaid released four policy updates effective September 1, 2026, including revisions to modifier usage (Modifier 25 and modifiers 59/XE/XP/XS/XU), dental services billing in facility settings, and infant formula coverage. The billing team must review each policy detail on CareSource.com to understand specific reimbursement rule changes before the effective date.
CareSource · Effective Sep 1, 2026High impact
[Ohio] July 2026 Policy Updates
CareSource Ohio Medicaid released 12 policy updates effective September 1, 2026 and October 1, 2026, including new reimbursement policies for Applied Behavior Analysis, EKG Interpretations, E/M and Psychotherapy, and dental anesthesia services, plus revisions to existing medical and administrative policies. Billing teams must review each policy individually on the CareSource website to identify specific code changes, documentation requirements, and billing rule updates before the effective dates.
CareSource · Effective Sep 1, 2026High impact
[Ohio] Pharmacy Policy Updates June 2026
CareSource Ohio Medicaid is updating 12 pharmacy policies effective September 1, 2026, including revised policies for specialty medications (ADZYNMA, AFLIBERCEPT, ECULIZUMAB, RITUXIMAB, SPINRAZA, SPRAVATO, UPLIZNA), oncology regimens, medical benefit medications, and one new policy for WASKYRA. Billing teams must review each updated policy for changes to prior authorization requirements, coverage criteria, and billing guidelines before the effective date.
CareSource · Effective Aug 24, 2026High impact
[Ohio] Same‑Day Billing Limits for Per Diem Behavioral Health Services
Effective August 24, 2026, CareSource will enforce same-day billing limits for behavioral health services in Ohio. When SUD IOP/PHP group counseling (H0015, H0015TG) is billed on the same day as TBS group services (H2020, H2012), providers may bill up to one hour of additional group services without prior authorization. Any additional group services exceeding one hour on the same date of service require prior authorization, and both services require PA when limits are exceeded.
CareSource · Effective Aug 21, 2026High impact
[Ohio] Inpatient Code Specificity-Additional Information
CareSource Ohio Medicaid is enforcing stricter inpatient diagnosis code specificity requirements, requiring providers to report the highest level of specificity (including laterality, anatomical location, and severity) rather than unspecified codes when documentation supports more detailed coding. This applies to approximately 3,500 diagnosis codes across all inpatient facility claims and will result in claim denials or rejections for unspecified codes when more specific alternatives are available in the same ICD-10-CM category.
CareSource · Effective Aug 13, 2026High impact
[Ohio] Appropriate Billing of Services
CareSource (Ohio Medicaid & MyCare) is enforcing 12 specific billing compliance initiatives aligned with Ohio Administrative Code rules, effective August 13, 2026. Providers must immediately audit billing practices for dialysis frequency limits, post-operative E&M bundling, incontinence supply limits, inpatient service bundling, sedation bundling, observation unit caps, readmission consolidation, behavioral health same-day restrictions, hospice/NF overlap denials, HCBS/institutional overlap denials, and OTP unit limits. Non-compliance will result in claim denials and payment interruptions.
CareSource · Effective Aug 1, 2026High impact
[Georgia] Prior Authorization Requirement Update
CareSource Georgia Medicaid is requiring prior authorization for 90+ new codes across multiple categories including durable medical equipment, hearing services, inpatient facility services, and outpatient diagnostics/services, effective August 1, 2026. Prior authorization will be mandatory for all nonparticipating providers and inpatient service requests.
CareSource · Effective Jul 29, 2026High impact
[Indiana] Third Party Liability (TPL)
CareSource has updated its Third Party Liability (TPL) policy for Indiana Medicaid members (Hoosier Healthwise and Healthy Indiana Plan). Providers must now bill third-party insurance resources BEFORE billing CareSource and submit documentation of the primary insurance explanation of payment with corrected claims. Claims submitted to CareSource without TPL billing documentation will be denied per federal regulation 42 CFR 433.139.
CareSource · Effective Jul 16, 2026High impact
[Georgia] Expired License/Certification and Provider Enrollment
CareSource Georgia Medicaid has clarified provider enrollment requirements regarding expired licenses and certifications. Providers must maintain current licenses, report expirations immediately, and understand the suspension/termination timeline: enrollment files are suspended the day after expiration, terminated 30 days after suspension if not remedied, with no retroactive re-enrollment allowed. Medical residents may use Residency Training Permits (RTP) only for outpatient prescription medications.
CareSource · Effective Jul 14, 2026High impact
[Indiana] Partial Hospitalization Program – Reminders
CareSource issued a reminder bulletin on Indiana Medicaid PHP services clarifying prior authorization requirements, billing limits, and service standards. Key requirements include: prior authorization is mandatory; only one H0035 unit per date of service is allowed; services must be provided at least four days per week for 4-6 hours of active therapy; and inpatient services cannot be billed on the same date as PHP. Failure to comply may result in claim denials or recoupments.
CareSource · Effective Jul 1, 2026High impact
[Georgia] August 2026 Pharmacy Policy Updates
CareSource Georgia Medicaid released five revised pharmacy policies effective July 1, 2026, covering medical benefit medications, off-label use medical necessity, multi-source brand medical necessity, preferred/non-preferred medication medical necessity, and multi-ingredient compound policies. The billing team must review each revised policy on CareSource.com to identify specific coverage, prior authorization, and documentation requirement changes before the July 1 effective date.
CareSource · Effective Jul 1, 2026High impact
[Georgia] July 2026 Pharmacy Policy Updates
CareSource Georgia Medicaid has revised five pharmacy-related policies effective July 1, 2026, covering medical benefit medications, off-label medical necessity, multi-source brand medical necessity, preferred/non-preferred medication medical necessity, and multi-ingredient compound policies. The document is a notification index only and does not contain specific policy details, changes, or billing impacts. Your team must access the full policy documents on CareSource.com to determine what changed and take appropriate action.
CareSource · Effective Jul 1, 2026High impact
[Ohio] OAC 5160-13-08, Add-On Payment for Nursing Facility-Based Hemodialysis Furnished by a Dialysis Center
Ohio Medicaid (CareSource) is implementing a new $110 per-treatment add-on payment for nursing facility-based hemodialysis services furnished by dialysis centers, effective July 1, 2026. Dialysis centers must bill using a designated HD revenue center code with an ODM-specified modifier to claim this add-on. The program is subject to a $2.1 million state budget cap and applies only during State Fiscal Year 2027 for dialysis centers already providing these services.
CareSource · Effective Jul 1, 2026High impact
[Ohio] OAC 5160-13-08, Add-On Payment for Nursing Facility-Based Hemodialysis Furnished by a Dialysis Center
Ohio Medicaid (ODM) has implemented a new add-on payment of $110 per treatment for nursing facility-based hemodialysis services furnished by dialysis centers, effective July 1, 2026. Billing teams must use the designated HD revenue center code with an ODM-specified modifier to claim this add-on payment, which is available only during SFY 2027, for dialysis centers already providing these services, and until the $2.1M budget cap is reached.
CareSource · Effective Jul 1, 2026High impact
[Ohio] June 2026 Policy Updates
CareSource Ohio Medicaid has released 9 policy updates affecting billing, documentation, and reimbursement practices. Most changes take effect August 1, 2026, including revisions to colonoscopy billing, DME modifiers, itemized billing requirements, and medical record documentation standards.
CareSource · Effective Jul 1, 2026High impact
[Ohio] June 2026 Policy Updates
CareSource Ohio Medicaid released consolidated policy updates effective July 1, 2026 (1 new policy) and August 1, 2026 (7 revised policies). Changes affect reimbursement policies for colonoscopy/sigmoidoscopy, DME modifiers, unlisted codes, and modifier usage; administrative policies for itemized billing, medical record documentation, and provider home visits; and a new medical policy for private duty nursing. Billing teams must review each policy on the CareSource website and implement changes by the effective dates to avoid claim denials.
CareSource · Effective Jul 1, 2026High impact
[Ohio] Behavioral Health Service Frequency Guidelines
Effective July 1, 2026, CareSource Ohio Next Generation MyCare & Medicaid is implementing new service frequency thresholds for behavioral health services. Prior authorization will be required once members exceed specified unit/day limits for withdrawal management, intensive outpatient programs, psychiatric support, and therapeutic services. Billing teams must track member utilization across all providers and obtain prior auth before services exceed thresholds to avoid claim denials.
CareSource · Effective Jul 1, 2026High impact
[Ohio] Vaccine for Children Program Administration Billing Guidance
Effective July 1, 2026, CareSource will reject vaccine administration claims billed with CPT codes 90471 or 90472 for VFC-covered toxoids when the provider is part of the VFC program. VFC providers must use CPT code 90460 instead for vaccine administration of covered toxoids.

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alert How Policy Monitoring works

[Ohio] Avalon Policy Updates

[Indiana] Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint

[Georgia] Claims Editing Enhancements

[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers

[Georgia] Administrative/Medical Policy Update (1/2)

[Indiana] October 2026 Policy Updates

[Georgia] Administrative/Medical Policy Update (2/2)

[Georgia] Medical Policy Update

[Georgia] November 2026 Pharmacy Policy Updates (1/3)

[Georgia] November 2026 Pharmacy Policy Updates (1/3)

[Georgia] November 2026 Pharmacy Policy Updates

[Georgia] November 2026 Pharmacy Policy Updates (2/3)

[Georgia] November 2026 Pharmacy Policy Updates (3/3)

[Indiana] November 2026 Policy Updates

[Indiana] November 2026 Pharmacy Policy Updates

[Ohio] November 2026 Policy Updates

[Georgia] Administrative Policy Update (1/2)

[Georgia] Administrative Policy Update (2/2)

[Ohio] November 2026 Pharmacy Policy Updates

[Georgia] October 2026 Administrative Policy Updates

[Georgia] October 2026 Pharmacy Policy Updates

[Indiana] October 2026 Pharmacy Policy Update

[Indiana] September 2026 Pharmacy Policy Updates

[Indiana] Important Notice about Part D Drug Coverage

[Georgia] September 2026 Pharmacy Policy Updates

[Ohio] September 2026 Policy Updates

[Ohio] Collecting Additional Information for Laboratory Services

[Ohio] August 2026 Policy Updates

[Ohio] Submission Requirements for Uniform Itemized Bills

[Ohio] Billing Guidance

[Ohio] Evaluation and Management (E/M) and Psychotherapy Add-On Billing Policy

[Ohio] Behavioral Health Time-based Service Documentation Requirement

[Indiana] July 2026 Policy Updates

[Ohio] July 2026 Policy Updates

[Ohio] Pharmacy Policy Updates June 2026

[Ohio] Same‑Day Billing Limits for Per Diem Behavioral Health Services

[Ohio] Inpatient Code Specificity-Additional Information

[Ohio] Appropriate Billing of Services

[Georgia] Prior Authorization Requirement Update

[Indiana] Third Party Liability (TPL)

[Georgia] Expired License/Certification and Provider Enrollment

[Indiana] Partial Hospitalization Program – Reminders

[Georgia] August 2026 Pharmacy Policy Updates

[Georgia] July 2026 Pharmacy Policy Updates

[Ohio] OAC 5160-13-08, Add-On Payment for Nursing Facility-Based Hemodialysis Furnished by a Dialysis Center

[Ohio] OAC 5160-13-08, Add-On Payment for Nursing Facility-Based Hemodialysis Furnished by a Dialysis Center

[Ohio] June 2026 Policy Updates

[Ohio] June 2026 Policy Updates

[Ohio] Behavioral Health Service Frequency Guidelines

[Ohio] Vaccine for Children Program Administration Billing Guidance