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.

Visit the Updates & Announcements page frequently to find all the latest CareSource news. We share updates regarding:

  • COVID-19 information
  • Pharmacy Information, including Single Pharmacy Benefit Manager (SPBM) and Unified Preferred Drug List (UPDL) and Provider Administered Drugs covered by CareSource
  • Medical, pharmacy, reimbursement and administrative policies
  • Authorization requirements as communicated through network notifications below 

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

COVID-19 Updates

Latest UpdatesDate
Navigate COVID-19: Vaccination Rx Provider Updates08/09/2022
Navigate COVID-19: Vaccination Program Updates07/15/2022
Navigate COVID-19: Vaccination Program Updates06/13/2022
Navigate COVID-19: Vaccination Program with Booster Updates06/13/2022
Navigate COVID-19: Vaccination Booster Program05/02/2022
Navigate COVID-19: Temporary Payment Policy for Immunizations Update05/02/2022
Navigate COVID-19: Vaccination Counseling Visit Coding Guidance05/02/2022
Navigate COVID-19: Vaccination Program Additional Codes02/25/2022
Navigate COVID-19: Oral Therapies02/21/2022
Navigate COVID-19: FQHC Vaccine Administration Bonus Payment Update01/18/2022
Navigate COVID-19: 2022 Vaccination Program Update01/01/2022
Navigate COVID-19: Vaccination Billing Guidelines Update12/15/2021
Navigate COVID-19: Temporary Change to Prior Authorization for Transition to Post-Acute Care – UPDATE11/05/2021
Navigate COVID-19: Vaccinations for Children 5-1111/01/2021
Navigate COVID-19: Vaccine Administration Rate Increase11/01/2021
Navigate COVID-19: Temporary Change to Prior Authorization for Transition to Post- Acute Care – This notification has been revised. See notification dated 11/05/2021.08/27/2021
Navigate COVID-19: Vaccination Member Incentive Update08/24/2021
Navigate COVID-19: Vaccination Member Incentive07/26/2021
Navigate COVID-19: Vaccine Administration Fee Bonus Payment – UPDATE06/25/2021
Navigate COVID-19: Vaccine Administration Rate Increase – UPDATE06/25/2021
Navigate COVID-19: Vaccine Administration Fee Bonus Payment – This notification has been revised. See notification dated 06/25/2021.06/23/2021
Navigate COVID-19: Vaccination Temporary Payment Policy Update06/17/2021
Navigate COVID-19: Vaccine Administration Fee Increase – This notification has been revised. See notification dated 06/25/2021.06/10/2021
Navigate COVID-19: Temporary Change to PAs for Transition to Post-Acute Care Update04/29/2021
Navigate COVID-19: Vaccination & Screening Collection/Processing Options03/08/2021
Navigate COVID-19: Vaccination Billing Guidance02/22/2021
Navigate COVID-19: Provider Vaccination Resources02/16/2021
Navigate COVID-19: Temporary Change to PAs for Transition to Post-Acute Care12/11/2020
Navigate COVID-19: SNF Prior Authorization Process Temporary Update – This network notification is being modified to reflect updated information.11/09/2020
Navigate COVID-19: State of Emergency Provider Guide Statement on Telehealth10/05/2020
Navigate COVID-19: Emergency Provisions Update07/21/2020
Navigate COVID-19: Prior Authorization Changes – UPDATE06/30/2020
Navigate COVID-19: Prior Authorization Guidance – This notification has been revised. See notification dated 06/30/2020.05/21/2020
Navigate COVID-19: Temporary Telehealth Services – UPDATE05/06/2020
Navigate COVID-19: Provider Stimulus Package Program Tool04/28/2020
Navigate COVID-19: Temporary Expansion for Molecular Diagnostic Testing for Influenza Virus Infection and Streptococcus A and B04/16/2020
Navigate COVID-19: Prior Authorization Guidance – This notification has been revised. See notification dated 05/21/2020.04/13/2020
Navigate COVID-19: Plan Collaboration for Long-Term Care04/09/2020
Navigate COVID-19: 90-Day Drug List04/07/2020
Navigate COVID-19: CDC Health Alert on Chloroquine04/07/2020
Navigate COVID-19: Temporary Telehealth Services – This notification has been revised. See notification dated 05/06/2020.04/03/2020
Navigate COVID-19: Temporary Telehealth Services – This notification has been revised. See notification dated 04/03/2020.03/27/2020
Navigate Protecting Members and Reducing the Spread of COVID-1903/13/2020

General Updates

2022Date
Navigate Program Delay: Phase 3 Launch of ODM Next Generation Managed Care11/18/2022
Navigate Provider Alternative Format Request11/10/2022
Navigate Next Generation December 1 Launch: Training and Resources11/1/2022
Navigate Policy Updates November 202211/1/2022
Navigate CareSource and TurningPoint Partnership for Cardiac and Musculoskeletal Surgical Procedures10/01/2022
Navigate Policy Updates October 202210/01/2022
Navigate OH MCD - October 2022 Versant Vision Policies Updates10/01/2022
Navigate Prescribing Exemption for Antidepressants and Atypical Medication Notification10/01/2022
Navigate Q4 Live Instructor-Led Provider Training and Education Series10/01/2022
Navigate Centralized Credentialing and PNM Portal Overview10/01/2022
Navigate Quarter 2 Avalon Medical Policy Update10/01/2022
Navigate Next Gen Managed Care Program: Do You Have Your OH|ID?09/30/2022
Navigate Preregister for the New PNM Module!09/23/2022
Navigate Ohio Medicaid Single Pharmacy Benefit Manager (SPBM)09/23/2022
Navigate Managed Care Claim Billing for Pharmaceuticals09/22/2022
Navigate Extended Payment Plan or Settlement This notification is an update to the network notification posted on 6/07/202209/13/2022
Navigate Pharmacy Policy Updates - October 202209/12/2022
Navigate October 2022 Provider Orientation and Education Live Webinar Invitation09/12/2022
Navigate The Ohio Department of Medicaid (ODM) Next Generation Program - Provider Updates for October 1 Launch09/06/2022
Navigate Policy Updates September 202209/01/2022
Navigate CLIA-Waived Tests Update08/22/2022
Navigate BH Provider Service Resolution Process Summary08/19/2022
Navigate Provider Alternative Format Request08/16/2022
Navigate Billing Update Re: Multiple Outpatient Claims08/15/2022
Navigate Life Services Referral Form08/12/2022
Navigate Billing Update: Incorrect Billing of Modifier 58 Notification08/10/2022
Navigate Quarter 1 2022 Avalon Medical Policy Update08/01/2022
Navigate Next Generation of Ohio Medicaid Managed Care: Payer ID Change08/01/2022
Navigate Policy Updates August 202208/01/2022
Navigate Next Generation of Managed Care: FQHC/RHC Prior Authorizations and Claims07/27/2022
Navigate Policy Updates - July 202207/21/2022
Navigate Ohio Medicaid Next Generation Program Provider Training Available07/20/2022
Navigate CareSource Live Instructor-Led Provider Training and Education Series07/07/2022
Navigate Pharmacy Policy Updates - July 202207/01/2022
Navigate Quarter 3 & 4 Avalon Medical Policy Update06/30/2022
Navigate We Want to Hear from You!06/30/2022
Navigate OhioRISE Launch: What Providers Need to Know06/27/2022
Navigate Extended Payment Plan or Settlement06/07/2022
Navigate Upload Claim Submissions Seamlessly in Provider Portal06/01/2022
Navigate Policy Updates June 202206/01/2022
Navigate Quarter 2 Avalon Medical Policy Update05/31/2022
Navigate Quarter 2 Avalon Reimbursement Policy Update05/31/2022
Navigate Group Prenatal Care05/23/2022
Navigate Lactation Consultants and Services05/23/2022
Navigate Post-Acute Care Prior Authorization Resumption05/11/2022
Navigate Policy Updates - May 202205/01/2022
Navigate June 2022 Provider Orientation Webinar Registration04/25/2022
Navigate Nurse Home Visit Launch04/25/2022
Navigate VaxCare LARC Inventory Platform04/12/2022
Navigate BH OAHP Readmission Policy04/12/2022
Navigate Billing Updates: Duplicate Discharge Day Management/ICD-10 7th Character and Therapy Proposal04/01/2022
Navigate Benefits of School-Based Health Centers for Ohio Students04/01/2022
Navigate Policy Updates - April 202204/01/2022
Navigate Pharmacy Policy Updates - April 202204/01/2022
Navigate Introducing Teladoc, CareSource’s New Telehealth Partner03/29/2022
Navigate Billing Updates: Chiropractic Unbundling and Duplicate Anesthesia03/23/2022
Navigate Quality Patient Experience Guide (CAHPS resource)03/18/2022
Navigate Maternal and Infant Support Program (MISP) update03/16/2022
Navigate Retro Authorization Submission Guidelines03/15/2022
Navigate Billing Update: Auxiliary Personnel - POS03/14/2022
Navigate Report of Pregnancy and Prenatal Risk Assessment Form Payment Update03/04/2022
Navigate Policy Updates March 202203/01/2022
Navigate Provider Portal Account Linking Enhancement02/21/2022
Navigate Policy Updates February 202202/01/2022
Navigate Annual Update - International Classification of Diseases, 10th Revision, Diagnosis Codes (ICD-10-CM)01/27/2022
Navigate NICU Authorization Process Update01/26/2022
Navigate Transportation Scheduling Now Available01/26/2022
Navigate Provider CLIA HCPCS Code Update01/01/2022
Navigate Policy Updates January 202201/01/2022
2021Date
Navigate 2021 Quarter 3 Provider Portal Updates12/31/2021
Navigate CareSource RxInnovations Ohio Medicaid Claims Processing Updates12/31/2021
Navigate 2021 Global Quality Enhancer: Value-Based Reimbursement Program12/29/2021
Navigate Clarification on Dental Electronic Payment Process Change12/28/2021
Navigate Continuous Glucose Monitor (CGM) Medical Benefit Change – UPDATE12/15/2021
Navigate Notice of Philips Respironics Voluntary Medical Device Recall - UPDATE12/15/2021
Navigate Additional Policy Updates December 202112/15/2021
Navigate ABA Provider Contracting & Credentialing Requirements12/15/2021
Navigate You’re Invited! CareSource Provider Webinar12/13/2021
Navigate Prior Authorization Requirement for Non-Participating Laboratory Services12/10/2021
Navigate Policy Updates December 202112/01/2021
Navigate ABA Claims Paying at Reduced Rate11/19/2021
Navigate Importance of the flu vaccination11/16/2021
Navigate Continuous Glucose Monitor (CGM) Medical Benefit Change11/15/2021
Navigate Policy Updates November 202111/01/2021
Navigate National Provider Identifier for Ordering, Referring and Prescribing Providers – UPDATE10/25/2021
Navigate HIPAA CORE Compliant Codes10/15/2021
Navigate Additional Policy Updates October 202110/15/2021
Navigate 2021-2022 Respiratory Syncytial Virus (RSV) Season and Synagis® Criteria10/13/2021
Navigate Policy Updates October 202110/01/2021
Navigate New Laboratory Benefit Management Program10/01/2021
Navigate Pfizer Vaccine Adherence in Kids (VAKs)09/24/2021
Navigate Hospice Claims Billing Guidance09/20/2021
Navigate Additional Policy Updates September 202109/17/2021
Navigate You’re Invited! CareSource Provider Webinar09/15/2021
Navigate Notice of Philips Respironics Voluntary Medical Device Recall - This notification has been revised. See notification dated 12/15/202109/13/2021
Navigate Additional Policy Updates September 202109/02/2021
Navigate Save the Date: Upcoming Provider Orientation Webinar09/02/2021
Navigate Policy Updates September 202109/01/2021
Navigate CareSource-Akron Pediatric Accountable Care Organization08/31/2021
Navigate Additional Policy Updates August 202108/12/2021
Navigate National Provider Identifier Requirement08/09/2021
Navigate Additional Policy Updates July 202108/03/2021
Navigate Policy Updates August 202108/01/2021
Navigate Waiver National Provider Identifier Requirement – UPDATE07/29/2021
Navigate You’re Invited! CareSource Provider Webinar07/22/2021
Navigate Non-Participating Provider Reimbursement Policy Update07/15/2021
Navigate Pharmacy Prior Authorization Provider Portal Enhancement07/13/2021
Navigate Electronic Visit Verification (EVV) Billing Guidance07/12/2021
Navigate Update in 90 Day Supply Drug List07/01/2021
Navigate Policy Updates July 202107/01/2021
Navigate CMS Interoperability06/22/2021
Navigate You’re Invited! CareSource Provider Webinar06/09/2021
Navigate Updates to Assist with Avalon Laboratory Benefit Management Transition06/04/2021
Navigate We Want to Hear From You!06/03/2021
Navigate Enteral Billing Updates06/01/2021
Navigate Policy Updates June 202106/01/2021
Navigate Save the Date: Upcoming Provider Orientation Webinar05/24/2021
Navigate Utilization Management Process05/18/2021
Navigate CareSource Partnership with Avalon Healthcare for Laboratory Benefit Management05/13/2021
Navigate Additional Policy Updates May 202105/06/2021
Navigate National Provider Identifier Needed – This notification has been revised. See notification dated 07/29/2021.05/06/2021
Navigate Policy Updates May 202105/01/2021
Navigate New Transportation Vendor04/30/2021
Navigate Prior Authorization Updates04/28/2021
Navigate UPDATE - Prior Authorization Requirements04/26/2021
Navigate National Provider Identifier for Ordering, Referring and Prescribing Providers – This notification has been revised. See notification dated 10/25/2021.04/14/2021
Navigate Policy Updates April 202104/01/2021
Navigate Ohio Medicaid Number Mandatory Requirement03/31/2021
Navigate Transplant Services Reimbursement Update03/11/2021
Navigate Policy Updates March 202103/01/2021
Navigate Equian Process Frequently Asked Questions02/18/2021
Navigate Community Behavioral Health Center Re-Credentialing Process02/16/2021
Navigate Annual Notification of Requirements02/12/2021
Navigate Provider Directory Changes for Optometry Service Providers Not Contracted with Superior Vision02/10/2021
Navigate 2020 Quarter 4 Provider Portal Updates02/01/2021
Navigate Policy Updates February 202102/01/2021
Navigate Update in Blood Glucose Meter and Test Strip Preferred Products01/18/2021
Navigate Care Coordination Information Exchange01/18/2021
Navigate Elective Transplant Process Change01/08/2021
Navigate Requirements for Preadmission Screening and Resident Review (PASARR) Process01/01/2021
Navigate Policy Updates January 202101/01/2021