Provider FastFax Library

1	Important Update on CMS Requirements for Oral-Only Phosphate Binders Effective January 1, 2025 (PDF)	1/6/2025
2	Vermont Regulatory Update Act 111 (Bill H.766) (PDF)	1/17/2025
3	Healthy Practices Newsletter is Now Available (PDF)	1/17/2025
4	Laboratory Policy Updates Effective April 1, 2025 (PDF)	1/31/2025
5	Provider and Payment Policy Updates Effective April 1, 2025 (PDF)	1/31/2025
6	Personalized Recovery Oriented Services (PROS) (PDF)	2/11/2025
7	Pharmacy Policy Update (PDF)	2/12/2025
8	Prior Authorization Update: eviCore Healthcare (PDF)	2/18/2025
9	Medical Policy Updates Effective April 1, 2025 (PDF)	2/26/2025
10	Pharmaceutical Policy Updates Effective April 1, 2025 (PDF)	2/26/2025
11	Pharmacy Formulary Updates Effective April 1, 2025 (PDF)	2/26/2025
12	Confirmation Needed: Your Provider Demographic Information (PDF)	2/28/2025
13	Crisis Residence Admissions Update (PDF)	3/4/2025
14	Changes to the New York State Patient Centered Medical Home (NYS PCMH)	3/13/2025
15	ACTION REQUIRED: Fiscal Intermediary Transition of Services	3/19/2025
16	Applied Behavior Analysis (ABA) Medical and Payment Policies Update	3/27/2025

1	DualAccess Cost Share & Training Update (PDF)	1/1/2024
2	MVP Scheduled System Downtime (PDF)	1/8/2024
3	HEDIS Operations Deadlines and Updates (PDF)	1/11/2024
4	Location Value Code Guidance and CHCBS Rural Rates (PDF)	1/17/2024
5	School-Based Mental Health (SBMH) Clinic Rate Enhancement (PDF)	1/17/2024
6	eviCore Healthcare updates (PDF)	1/18/2024
7	Crisis Intervention Authority and Reimbursement Changes (PDF)	1/31/2024
8	Children’s Crisis Intervention SPA Guidance Update (PDF)	2/19/2024
9	Pharmacy Formulary Updates Effective April 1, 2024 (PDF)	2/21/2024
10	Pharmaceutical Policy Updates Effective April 1, 2024 (PDF)	2/21/2024
11	Medical Policy Updates Effective April 1, 2024 (PDF)	2/21/2024
12	Providers Impacted by Change Healthcare Network Outage (PDF)	2/23/2024
13	Healthy Practices Is Now Digital (PDF)	2/27/2024
14	Crisis Intervention SPA Changes (PDF)	2/27/2024
15	Prior Authorization Update: eviCore Healthcare (PDF)	2/29/2024
16	Change Healthcare Network Outage - UPDATE (PDF)	3/7/2024
17	Confirmation Needed: Your Provider Demographic Information (PDF)	3/28/2024
18	MVP Outreach Campaign to Verify Your Information (PDF)	4/24/2024
19	Healthy Practices is Now Available (PDF)	4/25/2024
20	Medical Policy Updates Effective June 1, 2024 (PDF)	4/26/2024
21	Pharmaceutical Policy Updates Effective June 1, 2024 (PDF)	4/26/2024
22	Pharmacy Formulary Updates Effective June 1, 2024 (PDF)	4/26/2024
23	Laboratory Benefit Services to be Managed by Avalon Healthcare Solutions (PDF)	5/1/2024
24	New York State Essential Plan Coverage Expansion (PDF)	5/2/2024
25	Important Information from MVP HEDIS Operations (PDF)	5/9/2024
26	Annual Review of Clinical Criteria (PDF)	6/6/2024
27	Medical Policy Updates Effective August 1, 2024 (PDF)	7/1/2024
28	Pharmaceutical Policy Updates Effective August 1, 2024 (PDF)	7/1/2024
29	Pharmacy Formulary Updates Effective August 1, 2024 (PDF)	7/1/2024
30	Confirmation Needed: Your Provider Demographic Information (PDF)	7/2/2024
31	Execution of Clinical Criteria (PDF)	7/11/2024
32	Healthy Practices Newsletter is Now Available (PDF)	7/16/2024
33	Action Required—MVP At-Home Collection Kits Program (PDF)	7/22/2024
34	Avalon Laboratory Policies Delayed (PDF)	8/9/2024
35	Laboratory Policy Updates Effective September 15, 2024 (PDF)	8/16/2024
36	Pharmaceutical Policy Updates Effective October 1, 2024 (PDF)	8/26/2024
37	Pharmacy Formulary Updates Effective October 1, 2024 (PDF)	8/26/2024
38	Medical Policy Updates Effective October 1, 2024 (PDF)	8/26/2024
39	Opioid Treatment Bundled Services Billing Update (Action Required) (PDF)	8/28/2024
40	Scheduled Security Update of MVP Provider Online Accounts (PDF)	9/9/2024
41	MVP Scheduled System Downtime (PDF)	9/13/2024
42	Update Your MVP Provider Online Account (PDF)	9/16/2024
43	Updated Information Regarding Children in Foster Care (PDF)	9/24/2024
44	UVM Health Advantage Plan Will No Longer Be Offered in Vermont Starting January 1, 2025 (PDF)	9/26/2024
45	Healthy Practices Newsletter is Now Available (PDF)	10/22/2024
46	Pharmaceutical Policy Updates Effective December 1, 2024 (PDF)	10/30/2024
47	Pharmacy Formulary Updates Effective December 1, 2024 (PDF)	10/30/2024
48	Medical Policy Updates Effective December 1, 2024 (PDF)	10/30/2024
49	Action Required: Electronic Visit Verification (EVV) Attestation (PDF)	10/31/2024
50	Provider and Payment Policy Updates Effective January 1, 2025 (PDF)	11/1/2021
51	Confirmation Needed: Your Provider Demographic Information (PDF)	11/22/2024
52	Medical Policy Updates Effective February 1, 2025 (PDF)	11/26/2024
53	Pharmaceutical Policy Updates Effective January 1, 2025 (PDF)	11/26/2024
54	Pharmacy Formulary Updates Effective January 1, 2025 (PDF)	11/26/2024
55	Laboratory Policy Updates Effective February 1, 2025 (PDF)	11/27/2024
56	HEDIS Operations Deadlines and Updates (PDF)	12/4/2024
57	Optum to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments (PDF)	12/10/2024
58	Reminder: Electronic Visit Verification (EVV) Attestation (PDF)	12/12/2024
59	Pharmaceutical Policy Updates Effective February 1, 2025 (PDF)	12/19/2024
60	Changes to Medical and Pharmaceutical Policy Access (PDF)	12/23/2024
61	Adult and Youth Assertive Community Treatment (ACT) Redesign Billing Changes (PDF)	12/24/2024

1	Changes to Respite Telehealth Services Update (PDF)	1/5/2023
2	Changes to Billing and Payment of Evaluation and Management for Preventive and Sick Visits (PDF)	2/1/2023
3	Important Updates for Licensed Mental Health Counselor and Licensed Marriage and Family Therapist Services (PDF)	2/13/2023
4	Medical Policy Updates Effective April1, 2023 (PDF)	2/28/2023
5	Pharmacy Formulary Updates Effective April 1, 2023 (PDF)	2/28/2023
6	Pharmaceutical Policies Updates Effective April 1, 2023 (PDF)	2/28/2023
7	Medicaid Pharmacy Benefit Transitioning to New York State NYRx Medicaid Pharmacy Plan (PDF)	3/2/2023
8	Claims Submission Update (PDF)	3/3/2023
9	Pharmaceutical Policies Updates Effective April 1, 2023 (PDF)	3/6/2023
10	Online Provider Demographic Information Review Request (PDF)	3/30/2023
11	Prior Authorization Updates (PDF)	4/18/2023
12	Action Required: eMedNY/MMIS Annual Certification Statement (PDF)	4/19/2023
13	Pharmaceutical Policies Updates Effective June 1, 2023 (PDF)	4/25/2023
14	Medical Policy Updates Effective June 1, 2023 (PDF)	4/25/2023
15	Pharmacy Formulary Updates Effective June 1, 2023 (PDF)	4/24/2023
16	Annual Review of Clinical Criteria (PDF)	5/3/2023
18b	Recertifications Have Resumed for Medicaid, HARP, CHP, and EP (PDF)	5/8/2023
19	COVID-19 PHE Unwind announcement (PDF)	5/11/2023
20	Provider Survey Reminder (PDF)	5/16/2023
22	Prior Authorization Update: Magellan Health (PDF)	5/25/2023
23	Updated Payment Rules for Trabecular Bone Scans and Bone Density Studies (PDF)	6/14/2023
24	MVP Expands Network Coverage in New York State (PDF)	6/14/2023
25	Pharmacy Formulary Updates Effective August 1, 2023 (PDF)	6/27/2023
26	Pharmaceutical Policies Updates Effective August 1, 2023 (PDF)	6/27/2023
27	Medical Policy Updates Effective August 1, 2023 (PDF)	6/27/2023
28	Online Provider Demographic Information Review Request (PDF)	6/30/2023
29	MVP Health Care Offers Integrated Benefits D-SNP Plan in New York (PDF)	7/5/2023
30	Execution of Clinical Criteria (PDF)	7/6/2023
31	Pharmaceutical Policies Updates Effective September 1, 2023 (PDF)	7/27/2023
32	Pharmacy Formulary Updates Effective September 1, 2023 (PDF)	7/27/2023
33	Gaps In Care Webinar to be Offered in September (PDF)	7/28/2023
34	Medical policies Effective October 1, 2023 (PDF)	8/24/2023
35	Pharmacy Formulary Updates effective October 1, 2023 (PDF)	8/24/2023
36	Pharmaceutical Polices Updates Effective October 1, 2023 (PDF)	8/24/2023
37	Register for the MVP Gaps In Care Webinar (PDF)	8/29/2023
38	Important Updates for Article 29-I VFCA Health Facilities (PDF)	9/15/2023
39	GLP-1 Receptor Agonist Coverage Update (PDF)	9/29/2023
40	Online Provider Demographic Information Review Request (PDF)	10/2/2023
41	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments (New York) (PDF)	10/3/2023
41	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments (Vermont) (PDF)	10/3/2023
42	Changes to Medical and Pharmaceutical Policy Access (PDF)	10/4/2023
43	COVID-19 Vaccination Coverage Update (PDF)	10/20/2023
44	Pharmaceutical Polices Updates Effective December 1, 2023	10/26/2023
45	Medical Policy Updates Effective December 1, 2023	10/26/2023
46	Pharmacy Formulary Updates Effective December 1, 2023	10/26/2023
47	New Prescribing Provider Quality Incentive Program	10/31/2023
48	MVP Partners with LetsGetChecked to Offer Medicaid Members At-Home Kits to Complete Preventive Screenings	11/3/2023
49	Updates Regarding Care for Children in Foster Care	11/9/2023
50	Location Value Code Billing Change for CHCBS and CFTSS	11/21/2023
51	Pharmacy Formulary Updates Effective January 1, 2024	11/30/2023
52	Pharmaceutical Polices Updates Effective January 1, 2024	11/30/2023
53	Vermont Uniform Medical Prior Authorization Form Update	12/1/2023
54	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments	12/6/2023
55	Home Health Prior Authorization and Concurrent Review Process Changes	12/8/2023
57	Confirmation Needed: Your Provider Demographic Information	12/20/2023
58	Rochester Conversion Factor Table	12/20/2023
59	Buffalo Conversion Factor Table	12/20/2023
60	Pharmaceutical Policies Updates Effective February 1, 2024	12/28/2023
61	Pharmacy Formulary Updates Effective February 1, 2024	12/28/2023
62	Medical Policy Updates Effective February 1, 2024	12/28/2023

1	New Pharmacy Electronic Prior Authorization Process (PDF)	1/4/2022
2	Online Provider Demographic Information Review Request (PDF)	1/7/2022
3	Prior Authorization and Concurrent Review for Post-Acute Care Services (PDF)	1/11/2022
4	Community Oriented Recovery and Empowerment (CORE) Services (PDF)	1/13/2022
5	Medicare Reimbursement of COVID-19 Vaccines and Antibody Treatment (PDF)	1/14/2022
6	Children/Youth in Foster Care (PDF)	1/24/2022
7	MVP Medicaid SGLT2 Coverage (PDF)	1/31/2022
8	COVID-19 Vaccine Coding and Billing Reminder – Vermont Only (PDF)	2/18/2022
9	Updated Contact Information for Durable Medical Equipment Requests (PDF)	2/24/2022
10	Medical Policy Updates Effective April 1, 2022 (PDF)	2/25/2022
11	Pharmacy Formulary Updates Effective April 1, 2022 (PDF)	2/25/2022
12	Pharmaceutical Policies Updates Effective April 1, 2022 (PDF)	2/25/2022
13	Updated New York State Regulations for Medicaid Opioid Dependence Agents and Opioid Antagonists (PDF)	2/28/2022
14	KX Modifier Claims Processing (PDF)	3/18/2022
15	Online Provider Demographic Information Review Request (PDF)	4/1/2022
16	Claims Submission Update (PDF)	4/4/2022
17	Pharmacy Formulary Updates Effective June 1, 2022 (PDF)	4/28/2022
18	Pharmaceutical Policies Updates Effective June 1, 2022 (PDF)	4/28/2022
19	Medical Policy Updates Effective June 1, 2022 (PDF)	4/28/2022
20	Changes to Billing and Payment of Implantable Devices (PDF)	5/4/2022
21	Virtual Care and COVID-19 Treatment Cost-Share Update (PDF)	5/4/2022
22	Claims Submission Update (PDF)	5/25/2022
23	Annual Review of Clinical Criteria (PDF)	6/1/2022
24	Improving Medical Record Submissions to MVP For Quality Gaps in Care Processing (PDF)	6/3/2022
25	Pharmacy Formulary Updates Effective August 1, 2022 (PDF)	6/28/2022
26	Pharmaceutical Policies Updates Effective August 1, 2022 (PDF)	6/28/2022
27	Medical Policy Updates Effective August 1, 2022 (PDF)	6/28/2022
28	Online Provider Demographic Information Review Request (PDF)	7/6/2022
29	Claims Submission Update (PDF)	7/7/2022
30	Claims Submission Update (PDF)	7/7/2022
32	Execution of Clinical Criteria (PDF)	8/9/2022
33	BiPAP and CPAP Prior Authorization Updates (PDF)	8/25/2022
34	Changes to MVP Payment Summaries (PDF)	8/29/2022
35	Pharmacy Formulary Updates Effective October 1, 2022 (PDF)	8/30/2022
36	Pharmaceutical Policies Updates Effective October 1, 2022 (PDF)	8/30/2022
37	Medical Policy Updates Effective October 1, 2022 (PDF)	8/30/2022
38	Billing Changes for Dispensing Medication (PDF)	9/21/2022
39	Online Provider Demographic Information Review Request (PDF)	9/29/2022
40	Claims Submission Update (PDF)	10/26/2022
41	Pharmaceutical Policies Updates Effective December 1, 2022 (PDF)	10/27/2022
42	Pharmacy Formulary Updates Effective December 1, 2022 (PDF)	10/27/2022
43	Medical Policy Updates Effective December 1, 2022 (PDF)	10/27/2022
44	Applied Behavioral Analysis (ABA) Government Program Benefit Update (PDF)	11/8/2022
45	Dual Special Needs Program (D-SNP) ACTION REQUIRED: Complete Training (PDF)	11/16/2022
46	Medical Policy Updates Effective January 1, 2023 (PDF)	11/23/2022
47	Pharmaceutical Policies Updates Effective January 1, 2023 (PDF)	11/23/2022
48	Pharmacy Formulary Updates Effective January 1, 2023 (PDF)	11/23/2022
49	2022-49-mvp-health-care-hmo-plans-awarded-5-stars (PDF)	11/29/2022
50	Expanded Services Available for Child Health Plus (CHP) Members Effective January 1, 2023 (PDF)	12/16/2022

1A	Utilization Management Changes Due to COVID-19, Effective December 23, 2020 through February 21, 2021 (PDF)	01/12/21
2	COVID-19 Vaccine Reimbursement and Coding (PDF)	01/11/21
3	Important Developmental and Autism Screening Updates for Young Children (PDF)	02/08/21
4	Medical Policy Update: Applied Behavior Analysis (ABA) (PDF)	02/15/21
5	Medical Policy Updates Effective April 1, 2021 (PDF)	02/25/21
6	Pharmaceutical Policies Updates Effective April 1, 2021 (PDF)	02/25/21
7	Pharmacy Formulary Updates Effective April 1, 2021 (PDF)	02/25/21
8	MVP to Resume All Utilization Management Prior Authorization and Concurrent Review Programs Effective March 1, 2021 (PDF)	02/26/21
9	New Payment Policy: Robotic and Computer Assisted Surgery (PDF)	03/01/21
10	Update for Applied Behavior Analysis Indirect Services (PDF)	03/12/21
11	Medicaid Pharmacy Benefit Transitioning to New York State Medicaid Fee-for-Service (PDF)	03/12/21
12	Updated COVID-19 Vaccine Reimbursement and Coding – New York Only (PDF)	03/18/21
13	Updated COVID-19 Vaccine Reimbursement and Coding – Vermont Only (PDF)	03/18/21
14	Online Provider Demographic Information Review Request (PDF)	03/26/21
15	Evaluation and Management Payment Policy Update: Physician Diagnostic, Therapeutic and Preventive Injections (PDF)	04/02/21
16	COVID-19 Update – April 5, 2021 (PDF)	04/05/21
17	Project TEACH Educational Webinar (PDF)	04/08/21
18	Transition of Children in Voluntary Foster Care Into Medicaid Managed Care (PDF)	04/09/21
19	Pharmacy Formulary Updates Effective June 1, 2021 (PDF)	04/29/21
20	Pharmaceutical Policies Updates Effective June 1, 2021 (PDF)	04/29/21
21	Medical Policy Updates Effective June 1, 2021 (PDF)	04/29/21
22	Utilization Management Updates (PDF)	04/30/21
23	Medicaid Pharmacy Benefit Transition to New York State Medicaid Fee-for-Service Delayed (PDF)	05/07/21
24	Important Newborn Hearing Information (PDF)	06/04/21
25	Updates to Cost-Share (NY Only) (PDF)	06/09/21
26	Payment Policy Updates Effective September 15, 2021 (PDF)	06/19/21
27	Online Provider Demographic Information Review Request (PDF)	06/24/21
28	Annual Review of Clinical Criteria (PDF)	06/25/21
29	Voluntary Foster Care: Medication Transition (PDF)	06/29/21
30	Virtual Care and COVID-19 Treatment Cost-Share Update (PDF)	07/02/21
31	Billing Procedure Code Change for Diabetic Supplies – Vermont Only (PDF)	07/07/21
32	Pharmaceutical Policies Updates Effective September 1, 2021 (PDF)	07/19/21
33	Pharmacy Formulary Updates Effective September 1, 2021	07/19/21
34	Medical Policy Updates Effective August 1, 2021 (PDF)	07/19/21
35	New York State Medication-Assisted Treatment Formulary Change (PDF)	07/27/21
36	Applied Behavior Analysis for Medicaid Managed Care Plans (PDF)	08/26/21
37	Prior Authorization Change for Tufts Health Plan Members (PDF)	08/26/21
38	Pharmaceutical Policy Updates Effective October 1, 2021 (PDF)	08/27/21
39	Pharmacy Formulary Updates Effective October 1, 2021 (PDF)	08/27/21
40	Medical Policy Updates Effective October 1, 2021 (PDF)	08/27/21
41	Applied Behavior Analysis for Medicaid Managed Care Plans (PDF)	08/31/21
42	Execution of Clinical Criteria (PDF)	09/23/21
43	MVP Scheduled System Downtime (PDF)	09/24/21
44	Online Provider Demographic Information Review Request (PDF)	10/01/21
45	Update to Applied Behavior Analysis Services (PDF)	10/05/21
46	Regarding Certification for Utilization Pause for Prior Authorization and Concurrent Review, Acute Care and Post Acute Care Services (PDF)	10/13/21
47	MVP is Requesting Main Group Contact Information (PDF)	10/18/21
48	Pharmaceutical Policies Updates Effective December 1, 2021 (PDF)	10/28/21
49	Pharmacy Formulary Updates Effective December 1, 2021 (PDF)	10/28/21
50	Medical Policy Updates Effective December 1, 2021 (PDF)	10/28/21
51	MVP Health Care Announces New UVM Health Advantage Plans (PDF)	11/01/21
52	New Pharmacy Electronic Prior Authorization Process to Launch in December (PDF)	11/08/21
53	Pharmaceutical Policies Updates Effective January 1, 2022 (PDF)	11/29/21
54	Pharmacy Formulary Updates Effective January 1, 2022 (PDF)	11/29/21
55	Radiology Prior Authorization Updates (PDF)	11/30/21
56	Buffalo Conversion Factor Table (PDF)	12/01/21
57	Rochester Conversion Factor Table (PDF)	12/01/21
58	Improving Medical Record Transmission (PDF)	12/03/21
59	New Pharmacy Electronic Prior Authorization Process Now Available (PDF)	12/06/21
60	Pharmacy Formulary Updates Effective February 1, 2022 (PDF)	12/16/21
61	Pharmaceutical Policies Updates Effective February 1, 2022 (PDF)	12/16/21
62	Medical Policy Updates Effective February 1, 2022 (PDF)	12/16/21
63	Notifying MVP Health Care of New Tax Identification Numbers (TIN) (PDF)	12/22/21
64	Audio-Only Coding and Reimbursement Updates for Vermont Providers (PDF)	12/29/21
65	Prior Authorization Updates for Durable Medical Equipment (DME) (PDF)	12/30/21

1	IVF Pharmacy Policy Updates Effective (PDF)	01/01/20
2	Clinical Guidelines for HIV Pre-Exposure Prophylaxis (PDF)	01/31/20
3	Pharmacy Formulary Updates Effective 1/1/2020 (PDF)	01/31/20
4	Services Not Separately Reimbursed (PDF)	01/31/20
5	Epidural Limitations (PDF)	01/31/20
6	Coronavirus Update (as of 2/6/20) (PDF)	02/06/20
7	Payment Policy Updates Effective 1/1/2020 (PDF)	02/28/20
8	Influenca Testing Reimbursement (PDF)	02/18/20
9	Medical Policy Updates Effective 4/1/2020 (PDF)	02/24/20
10	Pharmacy Policy Updates Effective 4/1/2020 (PDF)	02/24/20
11	Formulary Updates Effective 4/1/2020 (PDF)	02/24/20
12	HPV Vaccinations (PDF)	03/04/20
14	Coronavirus Disease 2019 (COVID-19) Update (PDF)	03/09/20
15	Coding of COVID-19 Update (PDF)	03/13/20
16	Change in Behavioral Health Prior Authorization Requirements (PDF)	03/17/20
17	MVP Health Care Launches myERnow, Virtual ER Telemedicine Service (PDF)	03/18/20
18	Telemedicine Updates (PDF)	03/18/20
19	COVID-19 Update (as of 3/19/2020) (PDF)	03/19/20
20	Claims Status Process (PDF)	03/20/20
21	COVID-19 Update (as of 3/20/2020) (PDF)	03/20/20
22	COVID-19 Updates for Physical Therapists, Occupational Therapists, and Speech Therapists (as of 3/20/2020) (PDF)	03/20/20
23	COVID-19 Utilization Management Updates (as of 3/24/2020) (PDF)	03/24/20
24	COVID-19 Update (as of 3/27/2020) (PDF)	03/27/20
25	COVID-19 Medicare Update (as of 3/27/2020) (PDF)	03/27/20
26	COVID-19 Vermont Update (as of 3/30/2020) (PDF)	03/30/20
27	Online Provider Demographic Information Review Request (PDF)	03/31/20
28	COVID-19 Update (as of 4/8/2020) (PDF)	04/08/20
29	Utilization Management Changes Due to COVID-19 (PDF)	04/09/20
30	MVP Introduces New Online Provider Search Tool (PDF)	04/13/20
31	Pharmacy Formulary Updates Effective June 1, 2020 (PDF)	04/21/20
32	Pharmaceutical Policy Updates Effective June 1, 2020 (PDF)	04/21/20
33	Medical Policy Updates Effective June 1, 2020 (PDF)	04/21/20
34	Colorectal Screening for MVP Vermont Commercial Members (PDF)	04/23/20
35	Durable Medical Equipment (DME) Prior Authorization Updates (PDF)	04/24/20
36NY	New York COVID-19 Update as of May 7, 2020 (PDF)	05/07/20
36VT	Vermont COVID-19 Update as of May 7, 2020 (PDF)	05/27/20
37	Claims Status Update (as of 5/21/20) (PDF)	05/21/20
38	Annual Review of Clinical Criteria (PDF)	05/29/20
39	Diagnosis Matching Edits Policy Update (as of 5/29/20) (PDF)	05/29/20
40.1	Elective Procedures Prior Authorization Requirement Update (as of 6/2/20) (PDF)	06/02/20
41	Children’s Uniform Clinical Network Provider Training (PDF)	06/03/20
42	Provider Service Upgrades Interactive Voice Response (IVR) System (PDF)	06/18/20
43	COVID-19 Update – Behavioral Health Cost-Share (as of 6/15/20) (PDF)	06/15/20
44	Acute Care and Post-Acute Care Services Update (as of 6/16/20) (PDF)	06/16/20
45	Pharmacy Formulary updates effective August 1, 2020 (PDF)	06/25/20
46	Pharmaceutical Policy updates effective August 1, 2020 (PDF)	06/25/20
47	Default Pricing Change for Reimbursement effective October 1, 2020 (PDF)	06/30/20
48	Medical Policy updates effective August 1, 2020 (PDF)	06/25/20
49	Online Provider Demographic Information Review Request (PDF)	06/29/20
50	COVID-19 Update as of July 2, 2020 (PDF)	07/02/20
51	Scheduled System Downtime (PDF)	07/09/20
52	Payment Policy Updates as of July 15, 2020 (PDF)	07/15/20
53	System Downtime Scheduled for July 17, 2020 Postponed (PDF)	07/15/20
54	Behavioral Health Services Update: Utilization Management Changes Effective August 19, 2020 (PDF)	07/20/20
55	Execution of Clinical Criteria Effective August 1, 2020 (PDF)	07/22/20
56	Pharmacy Formulary Updates Effective September 1, 2020 (PDF)	07/30/20
57	Pharmaceutical Policies Updates Effective September 1, 2020 (PDF)	07/30/20
58	System Upgrade with Scheduled Downtime August 20, 2020 (PDF)	08/20/20
59	Closing Gaps-In-Care Utilizing Telemedicine Services (PDF)	08/21/20
62	Reduce the Burden of Gaps in Care Reporting (PDF)	09/02/20
63	Medical Policy Updates Effective October 1, 2020 (PDF)	09/03/20
64	COVID-19 Update – September 4, 2020 (PDF)	09/04/20
65	Personal Protective Equipment Update (as of 9/9/20) (PDF)	09/09/20
66	Atrial Fibrillation Ablation, Catheter-Based Medical Policy (PDF)	09/29/20
68	Arthroscopic, Endoscopic, and other Non-Endoscopic Scope Procedures Payment Policy (PDF)	10/01/20
69	Pharmacy Formulary Updates Effective December 1, 2020 (PDF)	10/28/20
70	Pharmaceutical Policies Updates Effective December 1, 2020 (PDF)	10/28/20
71	Medical Policy Updates Effective December 1, 2020 (PDF)	10/28/20
72	Clinical Guidelines for HIV Pre-Exposure Prophylaxis (PDF)	10/28/20
73	COVID-19 Testing Update – November 11, 2020 (PDF)	11/11/20
74	Multiple Procedure Reduction on the Technical Component of Diagnostic Cardiovascular and Ophthalmology Procedures Payment Policy (PDF)	11/05/20
75	New York State Delays Medication-Assisted Treatment Formulary Change (PDF)	11/12/20
76	Change to Pharmacy Networks (PDF)	11/19/20
77	Medical Policy Update Effective January 1, 2021 (PDF)	11/24/20
78	Pharmaceutical Policies Updates Effective January 1, 2021 (PDF)	11/24/20
79	Pharmacy Formulary Updates Effective January 1, 2021 (PDF)	11/24/20
80	Important Changes from MVP Health Care® (MVP) Regarding Prior Authorization for High Tech Radiology (PDF)	11/30/20
81	MVP Health Care® (MVP) Rochester Conversion Factor Table Effective as of January 1, 2021 Date of Service (PDF)	12/01/20
82	MVP Health Care® (MVP) Buffalo Conversion Factor Table Effective as of January 1, 2021 Date of Service (PDF)	12/01/20
83	New naviHealth Home Health Approval Processes (PDF)	12/07/20
84	Retrieval of Medical Records from Third-Party Vendors (PDF)	12/08/20
85	MVP Prior Authorization for Musculoskeletal Surgery Updates (PDF)	12/18/20
86	MVP Prior Authorization for Radiology Updates (PDF)	12/18/20
87	Skilled Nursing Home Utilization Management Changes Due to COVID-19 (PDF)	12/21/20
88	Actions to take for MVP Health Care® (MVP) Medicare Members (PDF)	12/22/20
89	Pharmacy Formulary Updates Effective February 1, 2021 (PDF)	12/23/20
90	Pharmaceutical Policies Updates Effective February 1, 2021 (PDF)	12/23/20
91	MVP Health Care Code of Ethics and Business Conduct Summary (PDF)	12/28/20
92	Online Provider Demographic Information Review Request (PDF)	12/30/20

1	New Medicare Opiate Edits for 2019 (PDF)	01/02/19
2	Help Us Fight the Opioid Epidemic (PDF)	01/03/19
3	MVP Health Care expands its collaboration with Vital Decisions (PDF)	01/30/19
4	Provide Opioid Feedback Before 2/22 Deadline (PDF)	02/08/19
5	Pharmaceutical policies available (PDF)	02/21/9
6	Pharmacy Formulary Updates effective 4/1/2019 (PDF)	02/26/19
7	Required Authorizations for Radiology Services (PDF)	02/27/19
8	naviHealth Peer-To-Peer Process Enhancements (PDF)	03/12/19
9	Medical Policies available (PDF)	03/13/19
10	Centers for Medicare & Medicaid Services (CMS) Health Outcome Surveys (PDF)	03/14/19
11	Online Provider Demographic Information Review Request (PDF)	03/28/19
12	Pharmaceutical Policies Available (PDF)	04/25/19
13	Pharmacy Formulary Updates Effective 6/1/2019 (PDF)	04/26/19
14	Nationally Renowned Pediatric Oncologist Joins MVP Health Care (PDF)	04/29/19
15	Payment Policy Updates Effective June 1, 2019 (PDF)	04/30/19
16	Medical Policies available for Providers (PDF)	05/01/19
17	Annual Review of Clinical Criteria (PDF)	05/02/19
18	Medicare Advantage Plans Introduce Condition Specific Benefits (PDF)	05/29/19
19	Payment Policy Updates: Services Not Reimbursed (PDF)	05/30/19
21	MVP Health Care Announces Next CEO, Christopher Del Vecchio (PDF)	06/12/19
22	Pharmacy Formulary Updates Effective 8/1/2019 (PDF)	06/19/19
23	Children and Family Treatment and Support Services Available as of July 1, 2019 (PDF)	06/20/19
24	Pharmaceutical Policies Available (PDF)	06/21/19
25	Online Provider Demographic Information Review Request (PDF)	06/25/19
26	Ongoing Measles Outbreak and Opioid Update (PDF)	06/27/19
27	MVP Payment Policy Update: After-Hours Services (PDF)	07/09/19
28	MVP Health Care to Transform Care Delivery Through New Integrated Health Initiative (PDF)	07/10/19
29	Execution of Clinical Criteria (PDF)	07/12/19
30	MVP Website Security Update, Provider Online Access (PDF)	07/15/19
31	Pharmaceutical Policies Available (PDF)	07/23/19
32	Pharmacy Formulary Updates Effective 9/1/2019 (PDF)	07/24/19
33	After-Hours Services Policy Clarification/Newsletter Update (PDF)	07/29/19
34	Pharmacy Formulary Updates Effective 10/1/2019 (PDF)	08/19/19
35	Pharmaceutical Policies Available (PDF)	08/20/19
36	Children’s Home and Community Based Services (PDF)	08/30/19
37	Medical Policies Available (PDF)	09/04/19
38	Important Lead Screening Updates for Young Children (PDF)	09/11/19
43	Payment Policy Clarification: Services Not Reimbursed (PDF)	09/24/19
39	Online Provider Demographic Information Review Request (PDF)	09/24/19
40	Global Edit Updates (PDF)	09/26/19
42	Medicaid Managed Care: Infertility Benefits Update (PDF)	09/27/19
41	Important Developmental Screening Updates for Young Children (PDF)	09/27/19
44	Updated HPV Vaccination Recommendations for U.S. Adults (PDF)	10/16/19
46	Pharmaceutical Policies Available (PDF)	10/22/19
45	Pharmacy Formulary Updates Effective 12/1/2019 (PDF)	10/22/19
50	IVF Pharmacy Policy Updates Effective 01/01/2020 (PDF)	11/18/19
49	Pharmaceutical Policies Available (PDF)	11/18/19
48	Pharmacy Formulary Updates Effective 1/1/2020 (PDF)	11/18/19
51	Important Newborn Hearing Information (PDF)	11/26/19
52	New Medicaid Managed Care Benefits (PDF)	11/27/19
56	New for 2020: Free Meal Delivery After Inpatient Hospitalization (PDF)	12/09/19
55	Pharmacy Tips and Best Practices (PDF)	12/09/19
58	Pharmacy Formulary Updates (PDF)	12/23/19
57	Pharmaceutical Policies Available (PDF)	12/23/19
60	Pediatric Lead Testing Program (PDF)	12/24/19
59	Online Provider Demographic Information Review Request (PDF)	12/24/19
62	MVP Health Care Code of Ethics and Business Conduct Summary (PDF)	12/31/19

1	Pharmaceutical Policies Available (PDF)	01/05/18
2	CMS Medicare Benefits and Beneficiary Protections (PDF)	01/10/18
3	1/1/18 Insulin Changes (PDF)	01/10/18
5	MVP Health Care Musculoskeletal Management Program Provider Education Webinars (PDF)	01/17/18
6	Improving Perinatal Care for Medicaid Members (PDF)	01/18/18
7	Musculoskeletal Management Program (PDF)	02/15/18
8	CMS Medicare Benefits and Beneficiary Protections (PDF)	02/16/18
9	Pharm Policies Available (PDF)	03/01/18
10	Pharm Formulary Updates (PDF)	03/02/18
11	Musculoskeletal Management Program (PDF)	03/16/18
12	CMS Medicare Benefits and Beneficiary Protections (PDF)	03/16/18
13	Online Provider Demographic Information Review Request (PDF)	03/29/18
14	CMS Medicare Benefits and Beneficiary Protections (PDF)	04/13/18
15	Annual Review of Clinical Criteria (PDF)	04/27/18
16	Pharm Policies Available (PDF)	04/30/18
17	Pharm Formulary Updates (PDF)	05/01/18
18	Online Provider Change of Information Form Available May 15 (PDF)	05/07/18
19	MVP Gaps in Care Reports (CNY); MVP Gaps in Care Reports (all others) (PDF)	05/08/18
21	CMS Medicare Benefits and Beneficiary Protections (PDF)	05/23/18
20	Surgical Supplies Reimbursement Policy Updates (PDF)	05/31/18
22	CMS Medicare Benefits and Beneficiary Protections (PDF)	06/14/18
23	Notice of discontinue of provider bonus incentives (PDF)	06/15/18
24	Online Provider Change of Information Form – Required for Use July 1, 2018 (PDF)	06/25/18
25	Online Provider Demographic Information Review Request (PDF)	06/26/18
26	Change in Prior Authorization Facility Based Sleep Studies Effective October 1, 2018 (PDF)	06/28/18
27	Execution of Clinical Criteria (PDF)	06/29/18
28	Vermont TeleHealth Billing and Reimbursement (PDF)	07/02/18
29	CMS Medicare Benefits and Beneficiary Protections (PDF)	07/06/18
30	Updated Provider Change and Patient Reassignment Request Form Now Available (PDF)	08/09/18
31	Pharmacy Policy Updates (PDF)	08/20/18
32	Pharmacy Formulary Updates, effective 8/1/18 (PDF)	08/16/18
33	Urgent Care Payment Policy (PDF)	08/30/18
34	CMS Medicare Benefits and Beneficiary Protections (PDF)	09/17/18
35	Pharmacy Formulary Updates, effective 9/1/18 (PDF)	09/20/18
36	MVP Health Care, Inc. Code of Ethics and Business Conduct Summary (PDF)	09/21/18
37	Online Provider Demographic Information Review Request (PDF)	09/25/18
39	Pharmaceutical policy updates available (PDF)	09/25/18
40	Correction to Payment Policy Updates ? Effective 1/1/19 (PDF)	09/30/18
41	Musculoskeletal Management Program (PDF)	09/28/18
42	Pharmacy Formulary Updates Effective 11/1/2018 (PDF)	10/29/18
43	Pharmaceutical Policies available for providers (PDF)	10/30/18
44	Office Consultation for Screening Colonoscopy (PDF)	11/01/18
46	Medical Policy updates available (PDF)	11/06/18
47	Diagnosis Matching Edits Policy Update (PDF)	11/15/18
48	New Children and Family Treatment and Support Services (CFTSS) Available Starting January 1, 2019 (PDF)	11/29/18
49	Pharmaceutical Policy Updates (PDF)	12/04/18
50	Pharmacy Formulary Updates Effective 12/1/2018 (PDF)	12/05/18
52	Pharmacy Formulary Updates Effective 1/1/19 (PDF)	12/21/18
53	Pharmaceutical Policies available for Providers (PDF)	12/20/18
54	Credentialing Update for MVP Providers (PDF)	12/26/18
55	Online Provider Demographic Information Review Request (PDF)	12/28/18

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