Provider Alerts Archive: 2026
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June 2026
- Change to questionnaires for select enteral nutrition services managed by BCN started June
- July 3 holiday closure: How to submit authorization requests for inpatient admissions
- Reminder: We added a step therapy requirement to Izervay for dates of service on or after April 1 for Medicare Advantage members
- We’re adding requirements for additional medical oncology drugs for most members starting Oct. 1
- e-referral system out of service for maintenance June 20-21
- Update: Changes to prior authorization requirements for select services managed by Blue Cross and BCN starting Feb. 1
- June 19 holiday closure: How to submit authorization requests for inpatient admissions
- Boruzu to require prior authorization for Blue Cross commercial URMBT members starting Sept. 9
- Ranluspec to require prior authorization for most commercial members starting June 15
- AOR not required for appeals of denied inpatient admissions for Medicare Plus Blue members
May 2026
- Check eligibility and benefits before prescribing CGM products for University of Michigan employer group members
- Referrals to home healthcare for Medicare Advantage members: Grace period extended through Sept. 30 for acute care providers
- Immgolis Intri IV to have a prior authorization and site of care requirement for most commercial members starting June 1
- Additional drugs to require prior authorization for Medicare Advantage members starting July 1
- Radiation oncology and radiopharmaceuticals to be managed through the Oncology Value Management program starting Sept. 1
- Blue Cross and Michigan Medicine reach contract agreement
- Changes to prior authorization requirements for select services managed by Blue Cross and BCN starting May 10 and May 24
- HelpScript enrollment service for manufacturer copay assistance will start July 1 for select medical benefit drugs for additional Blue Cross and BCN commercial members
- May 25 holiday closure: How to submit authorization requests for inpatient admissions
- Cinryze to require prior authorization for Medicare Advantage members starting June 1
- We're adding requirements for additional medical oncology drugs for most members starting Aug. 12
- Register for a Q&A session for acute care providers about changes for Medicare Advantage home health services managed by tango
- Streamlined process for first-time access to the WellSky provider portal through Availity Essentials
- Prior authorization process for noncovered services for Medicare Advantage members will change May 24
- Update: Providers should support patients to understand alternatives in preparation for Michigan Medicine leaving the Blue Cross and BCN networks on July 1
- e-referral system out of service for maintenance May 16-17
- Reminder: Q&A sessions available for home health agencies about changes for Medicare Advantage home health care managed by tango
- Retracted: Referrals to home health care for Medicare Advantage members: Grace period ends May 31 for acute care providers, continues for post-acute care and community-based providers
April 2026
- Otarmeni to require prior authorization for most members starting May 4 and July 1
- Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint
- We're changing the prior authorization process through e-referral for noncovered services for Medicare Advantage members
- Issue resolved: e-referral system temporarily unavailable
- Ponlimsi and Wainua to have requirements for most commercial members starting April 27
- Changes to prior authorization requirements for select services managed by Blue Cross and BCN starting April 12 and April 26
- Changes to prior authorization request process for endovascular intervention program starting April 26
- e-referral system out of service for maintenance April 18-19
- Avlayah IV and Kresladi IV to require prior authorization for most members starting April 6 and May 1
- Additional medical benefit drugs to require prior authorization for Blue Cross commercial URMBT members starting July 1
- Additional drugs to have a site-of-care requirement for most commercial and URMBT members starting July 1
March 2026
- e-referral system out of service for maintenance April 4-6
- Additional Q&A sessions available for home health agencies about changes for Medicare Advantage home health care managed by tango
- April 3 holiday closure: How to submit authorization requests for inpatient admissions
- Changes to prior authorization requirements for select services managed by Blue Cross and BCN effective March 15
- Additional drugs to require prior authorization for Medicare Advantage members starting June 22
- TurningPoint's SmartScan software now available April 15, training Q&A sessions available
- Pharmacists' scope of practice has expanded to include testing and treatment
- Pharmacists' scope of practice has expanded to include hormonal contraceptives
- e-referral system out of service for maintenance overnight March 21-22
- Retracted: Genio device to require prior authorization for commercial members starting May 1
- Correction to list of Procedure codes for which providers must request prior authorization
- Update: Learn more about tango’s management of home health care for Medicare Advantage members
- Register for a Q&A session for home health agencies about changes for Medicare Advantage home health care managed by tango
- Loargys to require prior authorization for most members starting March 9 and April 1
- Update: Michigan Medicine to terminate its Southeast Michigan hospitals, facilities and professionals from Blue Cross and BCN commercial networks July 1
February 2026
- Additional drugs to have a site-of-care requirement for most commercial members starting June 1
- Reminder: Tango to manage home health care for Medicare Advantage members starting March 1
- TurningPoint introduces software to assist with the prior authorization process for select musculoskeletal procedures
- Complete the Continuity of Care questionnaire in the e-referral system for some BCN commercial members starting Feb. 23
- Musculoskeletal procedures may require prior authorization through TurningPoint for FEP members
- Learn more about tango’s management of home health care for Medicare Advantage members
- e-referral system out of service for maintenance overnight February 21-22
- How we’re supporting the transition to tango for the management of home health care for Medicare Advantage members
- We’re adding requirements for additional medical oncology drugs for most members starting May 13
- Additional drugs to require prior authorization for Medicare Advantage members starting May 11
- Change to authorizations for SNF interrupted stays for Medicare Advantage members
- Prior authorization requirements for home health care services that start before March 1 for Medicare Advantage members
- Register for training to learn about changes to home health care for Medicare Advantage members
- Reminder: Home health agencies must contract with tango by March 2 to stay in network for Medicare Advantage members
- Update: Tango to coordinate referrals, manage prior authorizations and process claims for home health care for Medicare Advantage members starting March 1
- How to speed up the prior authorization process for Medicare Advantage SNF stays when submitting requests through the WellSky provider portal
January 2026
- Update: Changes to prior authorization requirements for select services managed by Blue Cross and BCN starting Feb. 1
- Complete and attach the Prospective Editing Reconsideration Request Form when submitting requests through Availity Essentials
- EviCore category assignments and practitioner performance summaries for PTs and OTs will be available Feb. 2
- A new questionnaire for referrals to out-of-network providers will open in the e-referral system for some office visit codes
- Correct mailing address, fax number for submitting appeals of denied inpatient admissions on behalf of Medicare Plus Blue members
- Leqvio and Zusduri to have requirements for Blue Cross commercial URMBT members starting April 15
- Yartemlea IV to require prior authorization for most members starting Jan. 19 and Feb. 2
- Reminder: How to check member eligibility and benefits in Availity Essentials without member ID or member ID prefix
- How to submit appeals of denied inpatient admissions on behalf of Medicare Advantage members to Grievance and Appeals
- Jan. 19 holiday closure: How to submit authorization requests for inpatient admissions
- e-referral system out of service for maintenance overnight January 17-18
- How to search for members in e-referral and avoid the inactive eligibility status
- Upload clinical documentation before launching Inspire V questionnaire in the e-referral system for commercial members
- Medicare Advantage post-acute and home health care update, including additional information about tango
- Register for a Q&A session about prior authorization changes for Medicare Advantage post-acute care
- Changes to Medicare Advantage process for requesting additional clinical information for inpatient authorizations starting Jan. 1
- Reminder: WellSky will manage prior authorization requests for post-acute care stays for Medicare Advantage members starting Jan. 5
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