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We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

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News

Louisiana Peoples Health Prior Authorization Process Change

Starting July 1, Peoples Health is changing the prior authorization submission process for certain Part B drugs.

Complete our training this Substance Use Prevention Month

Take our substance use disorder training to learn the most recent practice insights and earn free CME credits.

Texas Medicaid: State medication and prior authorization updates

On Oct. 15, 2025, we’re updating Texas Medicaid clinical prior authorization clinical criteria for certain medications.

Idaho Medicaid: New prior authorization requirements for radiation therapy

On Jan. 1, 2026, we’ll require prior authorizations for outpatient chemotherapy and radiation therapy services.

Texas Medicaid: Changes made to STAR+PLUS billing codes and modifiers

Effective Sept. 1, 2025, long-term care providers must use new billing codes and modifiers as members’ care plans renew.

IEX: Submission of medical documentation for surgery of hip and knee

CPT codes 27445, 27447, 27130 and 27132 will have additional documentation requirements, starting Aug. 1 for IEX.