ConnectiCare | Office Visit - September 2017
ConnectiCare
August 2017 Office Visit

October 2017 - In this issue

Preferred colony stimulating factory products
Statins will be covered as preventive for commercial plans only, starting Nov. 1
Medical record reviews start this month
New ConnectiCare center in Waterbury
ConnectiCare tools, resources and notifications
Recent provider headlines

Preferred colony stimulating factory products

Our preferred granulocyte-colony stimulating factor (G-CSF) drugs, as of Dec. 1, 2017, will be Granix® and Zarxio®, which are biosimilar products for Neupogen®. Granix and Zarxio will require preauthorization.

Neupogen and Neulasta® will not be preferred drugs and will require preauthorization.

This applies to all your ConnectiCare patients with commercial plans, including employer and individual policies.

As a reminder, all requests for chemotherapy and supportive agents, like Granix and Zarxio, as well as Neupogen and Neulasta, should be submitted to New Century Health (NCH), the care manager for our oncology management program.

If your patient continues to require colony stimulating factor products, such as Neupogen, Neulasta, Granix or Zarxio for treatment after Dec. 1, 2017, please submit preauthorization requests to NCH.

To submit requests:

Use the NCH secure website at my.newcenturyhealth.com (log in required), or
Call NCH’s Utilization Management Intake department at 1-888-999-7713, between 8 a.m. and 8 p.m. (ET), Monday through Friday.

NCH medical oncologists are available for peer-to-peer discussions on treatment regimens.

Statins will be covered as preventive for commercial plans only, starting Nov. 1

Generic versions of statin medications will be covered with no cost-share for your patients if the drugs are prescribed to prevent cardiovascular disease for individuals who may be at high risk. This is the result of new federal guidelines and is effective Nov. 1, 2017.

Here’s the information you need to know:

Who’s covered?
Adults age 40 to 75 years old with one or more cardiovascular risk factors, such as dyslipidemia or diabetes
ConnectiCare patients with commercial plans, including employer and individual policies
What’s covered?
Select generic strengths of low- to moderate-dose statins for primary prevention of cardiovascular disease
Examples
atorvastatin
fluvastatin
lovastatin
pravastatin
rosuvastatin
simvastatin

Medical record reviews to start this month

From now through April, ArroHealth may contact your office about reviewing medical records of your patients who have ConnectiCare commercial plans, including plans purchased through Access Health CT, the Connecticut exchange.

ArroHealth will conduct 2017 chart reviews on our behalf. As a health plan, we must submit accurate and complete diagnosis data for each member/patient to the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS).

As our partner and “business associate,” as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), ArroHealth is fully HIPAA compliant and is required to protect, preserve and maintain the confidentiality of any protected health information (PHI) obtained from clinical records provided by medical practices.

We appreciate your help. If you have questions, please call a ConnectiCare provider education and service representative at (860) 409-2468.

New ConnectiCare center in Waterbury

We opened a fourth sales-and-service center in Waterbury to help people enroll in 2018 plans, understand their coverage and help them get the care they need. The new store, open through the end of March 2018, is located at 835 Wolcott St. near Modell’s Sporting Goods and JOANN fabrics and crafts. Go to visitconnecticare.com for locations and hours of all our centers.

ConnectiCare tools, resources and notifications

Every year, we let our providers know about the tools and resources that are available to you and share information that is important for you to know. Learn more.

Recent provider headlines

Check out the latest Provider News & Headlines:

Information you need to know for the 2017-2018 flu season
Facility claims editing update
Claims update for chiropractic codes
Anticipate prescription drug questions from Medicare members
A reminder about advising patients on Medicare plan enrollment
We’re sending reminders to your patients
Has any of your information changed? Let us know.

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