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.

General Updates

2024Date
Navigate EDI Billing Updates02/15/2024
Navigate CareSource and CCHMC Partnership for Utilization Management for HealthVine Members02/09/2024
Navigate Policy Updates February 202402/01/2024
Navigate Pharmacy Policy Updates February 202402/01/2024
Navigate ODM Coding and Billing Reminder01/22/2024
Navigate Ohio Department of Medicaid (ODM) Rate Increases01/22/2024
Navigate Ohio Medicaid Invalid NDC & HIPPS Code Rejections01/19/2024
Navigate ODM Medicaid Agreement Revalidations - PNM01/19/2024
Navigate New Prior Authorization Requirement - Genomic Analysis Panel for Psychiatric Conditions (0345U)01/18/2024
Navigate CANS (H2000) Claim Denial Trend and Resolution Guidance01/12/2024
Navigate Newborn and NICU Prior Auth Requirement Update01/09/2024
Navigate 2024 Q1 CareSource Live Provider Education and Training Series01/08/2024
Navigate TurningPoint Policy Updates - January 202401/01/2024
Navigate Policy Updates - January 202401/01/2024
2023Date
Navigate Updates to Diabetes Benefits in 2024 – Quick Reference Guide12/31/2023
Navigate Coverage of DexCom & FreeStyle Continuous Glucose Monitors (CGMs)12/31/2023
Navigate Enhanced Reimbursement for Diabetes Self-Management Education12/31/2023
Navigate Quality Enhancer Incentive Program12/29/2023
Navigate Technical Assistance Intervention Package ePRAF12/29/2023
Navigate Home Health Services Calendar Limits12/06/2023
Navigate Provider Network Management (PNM) Module UpdateUPDATE12/04/2023
Navigate Avalon Policy Updates December 202312/01/2023
Navigate Policy Updates - December 202312/01/2023
Navigate Pharmacy Policy Updates December 202312/01/2023
Navigate CMS Implements New Code Edits11/13/2023
Navigate Pharmacy Policy Update - Beyfortus & Synagis11/09/2023
Navigate NIA Policy Updates - November 202311/01/2023
Navigate Policy Updates November 202311/01/2023
Navigate Provider Network Management (PNM) Module Update10/16/2023
Navigate Annual Notice of RequirementsUPDATE10/02/2023
Navigate Avalon Policy Updates (Q3/Q4) October 202310/01/2023
Navigate Avalon Policy Updates (Q1) October 202310/01/2023
Navigate Versant Policy Updates October 202310/01/2023
Navigate NIA Policy Updates October 202310/01/2023
Navigate Policy Updates October 202310/01/2023
Navigate DentaQuest Policy Updates - October 202310/01/2023
Navigate Policy Updates October 202310/01/2023
Navigate Annual Notice of RequirementsThis notification has been revised. See notification dated 10/02/202309/13/2023
Navigate Oncology Drug Shortage Notification09/13/2023
Navigate Coding and Billing Updates09/01/2023
Navigate Policy Updates September 202309/01/2023
Navigate September 2023 Avalon Policies - Effective 11/1/2309/01/2023
Navigate September 2023 Versant Vision Policies - Effective 11/1/2309/01/2023
Navigate 2023 Q3 and Q4 CareSource Live Provider Education and Training Series08/22/2023
Navigate Prior Authorization Requirement Update08/18/2023
Navigate Policy Updates August 202308/01/2023
Navigate Multi-Factor Authentication Implementation08/01/2023
Navigate Rejection of Claims that Bypass the ODM Fiscal IntermediaryUPDATE07/21/2023
Navigate Level 5 Evaluation and Management Claim Update07/21/2023
Navigate FREE Virtual CME Training Available!07/20/2023
Navigate Payment for Determination of Refractive State (92015)07/19/2023
Navigate Policy Updates July 202307/01/2023
Navigate Synagis Program Update06/22/2023
Navigate Pregnancy Risk Assessment Form (ePRAF) Education Series 06/21/2023
Navigate Enteral B Codes06/20/2023
Navigate DentaQuest Policy Updates June 202306/01/2023
Navigate Policy Updates June 202306/01/2023
Navigate Versant Policy Updates - May 202306/01/2023
Navigate Ohio Pulsewrx Program for Continuous Glucose Monitoring05/31/2023
Navigate 2023 Q2 CareSource Live Provider Education and Training Series05/25/2023
Navigate Closing Diabetes Retinopathy Screening Care Gap05/24/2023
Navigate Withdraw Approval of Makena05/22/2023
Navigate Rejection of Claims that Bypass the ODM Fiscal IntermediaryUPDATE05/10/2023
Navigate Public Health Emergency Ending - Resumption of Preadmission Screening and Resident Review (PASRR) Requirements05/05/2023
Navigate ODM Claims Rejection Logic05/04/2023
Navigate Rejection of Claims Based on the Provider Master File05/02/2023
Navigate Rejection of Claims that Bypass the ODM Fiscal Intermediary SummaryThis notification has been revised. See notification dated 5/10/202305/02/2023
Navigate Claims Readmission Policy04/12/2023
Navigate Public Health Emergency Ending – Updates to Benefits and Rates04/10/2023
Navigate CAHPS Email Campaign and Quality Patient Experience Guide04/03/2023
Navigate March 2023 OH MCD Turning Point Policy Updates04/01/2023
Navigate Prior Authorization Requirement for Non-Emergent NICU Transfers and Transports03/30/2023
Navigate Q1 2023 CareSource Live Instructor-Led Provider Training and Education Series UPDATE03/17/2023
Navigate ODM EDI Claims and Bridge Payments for Providers03/14/2023
Navigate Medicaid Coverage Redetermination Resumes April 103/10/2023
Navigate Pregnancy Risk Assessment Form (ePRAF) Education Series03/08/2023
Navigate Pulsewrx for Diabetes Monitoring03/06/2023
Navigate Policy Updates March 202303/01/2023
Navigate February 2023 Avalon Policy Updates03/01/2023
Navigate Pharmacy Policy Updates April 202302/27/2023
Navigate CareSource and AbsoluteCare Partner to Improve Health Outcomes02/22/2023
Navigate Q1 2023 CareSource Live Instructor-Led Provider Training and Education Series This notification has been revised. See notification dated 03/17/202302/21/2023
Navigate Electronic Data Interchange (EDI) Reminder02/17/2023
Navigate Guidance Regarding 270 Eligibility Inquiry, Claim Submissions and Payer ID02/13/2023
Navigate Next Generation of Ohio Medicaid Managed Care: Payer ID Change - UPDATE01/31/2023
Navigate Program Delay - Phase 3 Launch of ODM Next Generation Managed Care - UPDATE01/27/2023
Navigate Next Generation December 1 Launch Training and Resources - UPDATE01/27/2023
Navigate CareSource and TurningPoint Partnership for Cardiac and Musculoskeletal Surgical Procedures - UPDATE01/26/2023
Navigate Ohio Next Generation Managed Care: New ODM Communication Available01/24/2023
Navigate Postpartum Depression Screening Promotion01/09/2023
Navigate Medicaid Advisory Letter (MAL) 666 Update01/06/2023
Navigate Next Generation December 1 Launch Training and Resources - UPDATE01/05/2023
Navigate Readmission Pre-Pay Claims Review01/03/2023