Health Alliance Plan of Michigan (HAP) November 2017 Medical Policy Updates

Health Alliance Plan Of Michigan (HAP) Medical Policy Updates
Health Alliance Plan of Michigan (HAP) Medical Policy Updates

Click here to view the Health Alliance Plan of Michigan (HAP) November 2017 Medical Policy Updates »

 

Recent Changes November 2017;

  • Acoustic Pharyngometry
  • Agalsidase Beta (Fabrazyme®)
  • Anti-Cancer Drugs
  • Aralast NP, Zeimara, Glassia, Prolastin, Prolastin-C (human alpha1-proteinase inhibitor)
  • Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma, PRP)
  • Avastin® (Bevacizumab) for Oncology
  • Breast Prosthesis (External) and Related Supplies Following Mastectomy or Lumpectomy
  • Breath Test for the Detection of Heart Transplant Rejection
  • Cervical Cancer Screening Visualization Technologies (Cervicography, Speculoscopy, and Spectroscopy)
  • Complementary, Alternative, Holistic or Natural Medicine
  • Compounded Medications
  • Computer Assisted Corneal Topography
  • Computer-Aided Detection of Chest Radiographs for Lung Cancer Screening
  • Corneal Graft with Amniotic Membrane Transplant or Limbal Stem Cell Transplantation
  • Denosumab (Prolia®)
  • Denosumab (Xgeva®)
  • Diapers, Incontinence Liners, Pants, Youth Pull On Briefs, and Underpads
  • Drug Therapy for Smoking Cessation – OTC Smoking Cessation Products
  • Eculizumab (Soliris®)
  • Edaravone (Radicava™)
  • Hair (Eyebrow) Transplant
  • Heart, Lung and Heart-Lung Transplantation
  • Hepatic Lesions, Tumors or Metastases; Treatment Approaches (Combining two existing policies: Liver and Other Neoplasms – Treatment Approaches and Ablation of Hepatic Lesions)
  • Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
  • Immune Globulin (Human)
  • Kidney Transplantation, Pancreas-Kidney Transplantation, and Pancreas Transplantation Alone
  • Pediatric Intensive Feeding Programs
  • Photocoagulation Laser Treatment of Macular Drusen
  • RSV Prevention Vaccine, Palivizumab (Synagis®)
  • Sacral Nerve Stimulation for Urinary Voiding Dysfunction and Fecal Incontinence
  • Signal-Average Electrocardiography (SAECG) (renamed from: Computerized Electrocardiography (ECG) Analysis)
  • Stem-Cell Transplant for Autoimmune Diseases
  • Stem-Cell Transplant for Sickle Cell Disease and Thalassemia Major
  • Treatments for Hereditary Angioedema (HAE): Human C1 Esterase Inhibitor (Cinryze®), Human C1 Esterase Inhibitor (Berinert®), Human C1 Esterase Inhibitor (Haegarda®), Ecallantide (Kalbitor®), Icatibant (Firazyr®)
  • Tumor Ablation, Malignant or Benign (including Cryoablation, Radiofrequency Ablation, Microwave Ablation, High Intensity Focused Ultrasound)
  • Tumor Markers for Cancer
  • Yag Laser (1064 nm neodymium-doped yttrim aluminum garnet [Nd:YAG] laser) for Hidradenitis Suppurativa (acne inversa)
  • ZZ – Retired Policy – CRYOABLATION OF BREAST LESIONS
  • ZZ – Retired Policy – CRYOABLATION OF RENAL TUMORS
  • ZZ – Retired Policy – CRYOSURGERY/CRYOABLATION OF THE PROSTATE
  • ZZ – Retired Policy – Hammer Toe Surgery
  • ZZ – Retired Policy – HIGH INTENSITY FOCUSED ULTRASOUND (HIFU)
  • ZZ – Retired Policy – MICROWAVE THERMOTHERAPY FOR BREAST CANCER
  • ZZ – Retired Policy – PRODUCTION GLOVE
  • ZZ – Retired Policy – RADIOFREQUENCY ABLATION (RFA) OF PULMONARY TUMORS
  • ZZ – Retired Policy – Radiofrequency Ablation of Breast Cancer
  • ZZ – Retired Policy – RADIOFREQUENCY TUMOR ABLATION
  • ZZ – Retired Policy – UTERINE ARTERY EMBOLIZATION FOR THE TREATMENT OF UTERINE FIBROIDS

 

Click here to view the Health Alliance Plan of Michigan (HAP) November 2017 Medical Policy Updates »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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