Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

General Updates

2026Date
Navigate Pharmacy Policy Updates June 202606/01/2026
Navigate Policy Updates June 202606/01/2026
Navigate Evolent Healthcare Advanced Radiology Policy Revision Notice06/01/2026
Navigate Policy Updates May 202605/01/2026
Navigate Evaluation and Management Coding Review04/27/2026
Navigate Cultural Competency04/24/2026
Navigate Pharmacy Policy Updates April 202604/01/2026
Navigate Avalon Policy Updates Q3/Q4 202504/01/2026
Navigate Policy Updates April 202604/01/2026
Navigate Site of Care Management Program04/01/2026
Navigate Prior Authorization Requirement Update03/25/2026
Navigate Policy Updates March 202603/01/2026
Navigate Evaluation and Management (E&M) Consultation Codes02/03/2026
Navigate Policy Updates February 202602/01/2026
Navigate TurningPoint Policy Updates February 202602/01/2026
Navigate Evolent Policy Updates February 202602/01/2026
Navigate Prepay Auditing Update01/29/2026
Navigate Policy Updates January 202601/01/2026
2025Date
Navigate Urgent Medical Device Correction - FreeStyle Libre 3 and FreeStyle Libre 3 Plus Sensors12/26/2025
Navigate Policy Updates December 202512/01/2025
Navigate Pharmacy Policy Updates December 202512/01/2025
Navigate Pharmacy Policy Updates December 202512/01/2025
Navigate Lymphedema Compression Treatment Items Claims Editing Enhancements11/24/2025
Navigate Policy Updates November 202511/01/2025
Navigate Launch of HealthPlanResources.com10/22/2025
Navigate Claims Editing - Add-On Codes, E/M and Special Services10/20/2025
Navigate Claim Edits for Durable Medical Equipment10/17/2025
Navigate New Claim Condition Code Requirements10/15/2025
Navigate Newborn RSV Prevention10/03/2025
Navigate Close Diabetes Care Gaps and Enhance Diabetes Eye Health Outcomes10/02/2025
Navigate Policy Updates October 202510/01/2025
Navigate Policy Updates September 202509/01/2025
Navigate Pharmacy Policy Updates September 202509/01/2025
Navigate CareSource Edifecs CRA Solution08/21/2025
Navigate 2025 DSF-E HEDIS Measure08/15/2025
Navigate Follow-up After Hospitalization for Mental Illness (FUH) Measure Update08/15/2025
Navigate Policy Updates August 202508/01/2025
Navigate Newborn Claims Billing Information07/31/2025
Navigate Avalon Policy Updates - Q2 202507/01/2025
Navigate Policy Updates July 202507/01/2025
Navigate Coding Documentation Guides Available06/26/2025
Navigate Policy Updates June 202506/01/2025
Navigate Pharmacy Policy Updates June 202506/01/2025
Navigate Provider Focus Group Invite05/19/2025
Navigate Pharmacy Policy Updates May 202505/16/2025
Navigate 2025 Prior Authorization Update05/02/2025
Navigate Policy Updates May 202505/01/2025
Navigate Prothesis and Orthosis Claims Editing Logic04/10/2025
Navigate 2024 HHS-RADV Audit Begins May 202504/04/2025
Navigate Medical Record Reviews04/02/2025
Navigate Pharmacy Policy Updates April 202504/01/2025
Navigate Policy Updates April 202504/01/2025
Navigate Avalon Policy Update - April 202504/01/2025
Navigate It's Patient Experience Survey Season03/14/2025
Navigate Pharmacy Policy Updates March 202503/01/2025
Navigate Policy Updates March 202503/01/2025
Navigate Avalon Policy Updates - Q4 202403/01/2025
Navigate Hospital-Based Clinic Visits – Expired02/19/2025
Navigate Policy Updates February 202502/01/2025
Navigate Avalon Policy Update - February 202502/01/2025
Navigate Policy Updates November 2024 – Revision01/02/2025
Navigate Policy Updates January 202501/01/2025
Navigate Updating Demographics01/01/2025