Medicaid Provider Updates

Provider Information Regarding COVID-19

Highmark Wholecare Providers can review updates regarding COVID-19. Click here to access the updates.

Medicaid Provider Updates
Sept 2022 Important Provider Notice - HealthChoices Program
Sept 2022 Notice of Medicaid Policy Updates For Oct 1
Aug 2022 Acute Migraine Treatment-GEPANTS Require Prior Authorization
Aug 2022 Short Acting Opioids (Including Tramadol) Require Prior Authorization
Aug 2022 New Address For Paper Claims
July 2022 Notice of Medicaid Policy Updates For Sept 1
July 2022 Pennsylvania HealthChoices (PHC) Special Enrollment Period
July 2022 Notice of Medicaid Policy Updates For Aug 1
July 2022 Authorization Requirements Medicare - Jul 1
June 2022 Provider Webinars: 2022 Annual Provider Education
June 2022 Health Choices Contract FAQ
June 2022 Shortage of Iodinated Contrast Agents
June 2022 Notice of Medicaid Policy Updates For July 1
May 2022 NaviNet® and Enhanced Provider Portal Update
May 2022 ICD-10-CM Excludes Notes Training - June 3,2022
May 2022 Medications to Require Medical Prior Authorization, Effective July 1
May 2022 Population Assessment Article
May 2022 Prior authorization requirements for Sleep, Radiation Oncology and Cardiology began on April 1, 2022
May 2022 Notice of Medicaid Policy Updates For June 1
Apr 2022 Upcoming Provider Webinars
Apr 2022 Payment Cycle Update
Feb 2022 Medications to Require Medical Prior Authorization, Effective Apr 1
Feb 2022 Removal of Select Authorization Requirements for Medicare and Medicaid
Feb 2022 New Authorization Requirements for Sleep, Radiation Oncology and Cardiology - Revision
Feb 2022 February 21st-27th is National Eating Disorders Awareness Week
Jan 2022 Authorization Requirements Medicaid - Jan 17
Jan 2022 Medications to Require Medical Prior Authorization, Effective Feb 21
Jan 2022 Outpatient Laboratory Services
Jan 2022 Navinet - Eligibility and Benefits Screen Update
Jan 2022 New Authorization Requirements for Sleep, Radiation Oncology and Cardiology


This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 27 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

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