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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

July 2018

Highlights
Medicare Advantage: New Payment Policy Regarding Inpatient Admissions

Harvard Pilgrim has developed an Inpatient Acute Medical Admissions Payment Policy for Medicare Advantage members, which is effective for dates of service beginning Sept. 1, 2018.

Read more


New Online Behavioral Health Pilot Program

Harvard Pilgrim is launching a pilot this month with AbleTo, a structured eight-week online health program that connects commercial members with a professional therapist and coach.

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CT Pilot Program: GlucoseZone for Personalized Diabetes Management

Harvard Pilgrim is introducing GlucoseZone, a digital health solution for exercise-based diabetes management, as a 6-month pilot to members of employer group plans in Connecticut identified as having diabetes or pre-diabetes.

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Coverage of Newly Approved Medications With Prior Authorization

Harvard Pilgrim will be covering several newly FDA-approved drugs for our commercial members, effective for dates of service beginning Sept. 1, 2018.

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Payment Policy Updates: SNF and Rehabilitation Facility/LTAC

Harvard Pilgrim regularly reviews our payment policies to ensure that coding and reimbursement information is captured as completely and accurately as possible.

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HPHCURRENT EVENTS

Medicare Advantage: New Payment Policy Regarding Inpatient Admissions

New Online Behavioral Health Pilot Program

CT Pilot Program: GlucoseZone for Personalized Diabetes Management

CLINICIAN CORNER

Update to Harvard Pilgrim’s Gynecomastia Medical Review Criteria

Temodar and Zoladex Prior Authorization Updates

Coverage of Newly Approved Medications With Prior Authorization

Suicide Prevention Resources

OFFICE ASSISTANT

Payment Policy Updates: SNF and Rehabilitation Facility/LTAC

Hierarchical Condition Categories Coding Reminders

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator