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

March 2019

Highlights
Harvard Pilgrim Network Meeting: Sign Up for the Mass. Event

On the heels of our successful event in New Hampshire, we’re continuing our regional network engagement series in Massachusetts on April 3, 2019, with more to follow.

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Update: Emergency Care and Controlled Substances

Harvard Pilgrim recently updated our Emergency Care Payment Policy to underscore the importance of meeting state and federal rules that apply when a Schedule II, III, or IV controlled substance is prescribed, including any mandated review through a prescription drug monitoring program.

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Updates to Medical Policies

Harvard Pilgrim regularly reviews our commercial medical policies and prior authorization criteria and makes updates based on the current clinical literature and best practices.

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Udenyca Now Covered with Prior Authorization

Harvard Pilgrim now covers the medication Udenyca for members of our commercial plans.

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Guidance Regarding Procedures Designated as a “Separate Procedure”

Harvard Pilgrim would like to remind our provider network that if a procedure code’s description includes the term “separate procedure,” that code should not be reported when performed alongside another procedure in an anatomically related region.

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Network Matters Archives

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HPHCURRENT EVENTS

Harvard Pilgrim Network Meeting: Sign Up for the Mass. Event

CLINICIAN CORNER

Update: Emergency Care and Controlled Substances

Updates to Medical Policies

Udenyca Now Covered with Prior Authorization

Reminder: Anser IFX, UST, and VDZ Tests Not Covered

OFFICE ASSISTANT

Guidance Regarding Procedures Designated as a “Separate Procedure”

Keep Panel Status and Demographic Information Up to Date

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator