Provider FastFax Library

2026

1

Implementation of the Avalon Healthcare Solutions Precision Genetic Testing Management Policies

1/16/2026

1	Important Update on CMS Requirements for Oral-Only Phosphate Binders Effective January 1, 2025	1/6/2025
2	Vermont Regulatory Update Act 111 (Bill H.766)	1/17/2025
3	Healthy Practices Newsletter is Now Available	1/17/2025
4	Laboratory Policy Updates Effective April 1, 2025	1/31/2025
5	Provider and Payment Policy Updates Effective April 1, 2025	1/31/2025
6	Personalized Recovery Oriented Services (PROS)	2/11/2025
7	Pharmacy Policy Update	2/12/2025
8	Prior Authorization Update: eviCore Healthcare	2/18/2025
9	Medical Policy Updates Effective April 1, 2025	2/26/2025
10	Pharmaceutical Policy Updates Effective April 1, 2025	2/26/2025
11	Pharmacy Formulary Updates Effective April 1, 2025	2/26/2025
12	Confirmation Needed: Your Provider Demographic Information	2/28/2025
13	Crisis Residence Admissions Update	3/4/2025
14	Changes to the New York State Patient Centered Medical Home (NYS PCMH) >	3/13/2025
15	ACTION REQUIRED: Fiscal Intermediary Transition of Services	3/19/2025
16	Applied Behavior Analysis (ABA) Medical and Payment Policies Update	3/27/2025
17	Healthy Practices Newsletter is Now Available	4/15/2025
18	CHCBS Services Available to Child Health Plus Members	4/22/2025
19	Pharmaceutical Policy Updates Effective June 1, 2025	4/30/2025
20	Pharmacy Formulary Updates Effective June 1, 2025	4/30/2025
21	Medical Policy Updates Effective June 1, 2025	4/30/2025
22	Provider and Payment Policy Updates Effective July 1, 2025	5/1/2025
23	MVP Partnering with Zelis for EFT/ERA	5/16/2025
24	Laboratory Policy Updates Effective August 1, 2025	5/30/2025
25	MVP to transition to MVP Insights Powered by Arcadia	6/4/2025
26	MVP is participating with CAQH to utilize their Provider Data Portal	6/9/2025
27	Annual Review of Clinical Criteria	6/20/2025
28	Pharmaceutical Policy Updates	6/27/2025
29	Pharmacy Formulary Updates Effective August 1, 2025	6/27/2025
30	Confirmation Needed: Your Provider Demographic Information	6/30/2025
31	Beware of Medicare Fraud Scheme Involving Phishing Fax Requests	7/10/2025
32	Healthy Practices Newsletter is Now Available	7/11/2025
33	Medical Policy Updates Effective August 1, 2025	7/14/2025
33.1	Pharmaceutical Policy Updates Effective September 1, 2025	9/29/2025
33.2	Pharmacy Formulary Updates Effective September 1, 2025	9/29/2025
34	Reminder: MVP’s Partnership with Zelis	7/15/2025
35	Execution of Clinical Criteria	8/6/2025
36	Community Physician Postpartum Visit Program	8/7/2025
37	Provider and Payment Policy Updates Effective October 1, 2025	8/7/2025
38	Formulary Updates Effective October 1, 2025	9/2/2025
39	Pharmaceutical Policy Updates Effective October 1, 2025	9/2/2025
40	Medical Policy Updates Effective October 1, 2025	9/2/2025
41	MVP Scheduled System Downtime	9/16/2025
42	Notice: MVP’s Transition from Payspan to Zelis	9/24/2025
43	MVP ending relationship with naviHealth December 31, 2025	10/1/2025
44	Telehealth Flexibilities and Possible Expiration	10/1/2025
45	MVP to Expand Partnership with Avalon Healthcare Solutions	10/2/2025
46	Changes to 2026 Medicare Advantage Plan Offering	10/15/2025
47	Healthy Practices Newsletter is Now Available	10/17/2025
48	Medical Policy Updates	10/24/2025
49	Formulary Updates Effective December 1, 2025	10/24/2025
50	Pharmaceutical Policy Updates	10/24/2025
51	Precision Genetic Testing Management Policies Effective January 1, 2026	10/30/2025
52	Provider and Payment Policy Updates Effective January 1, 2026	10/31/2025
53	Applied Behavior Analysis Services Updates	11/5/2026
54	Update: MVP’s Transition from Payspan to Zelis	11/7/2025
55	MVP partnering with Attac Consulting Group	11/7/2025
56	Independent Health to Join MVP Health Care’s Family of Companies	11/18/2025
57	Pharmacy Policy Updates Effective January 1, 2026	12/1/2025
58	Pharmacy Formulary Updates Effective January 1, 2026	12/1/2025
59	Laboratory Policy Updates Effective February 1, 2026	12/2/2025
60	Oral-Only Phosphate Binders Effective January 1, 2026	12/2/2025
61	Reminder: New procedure for Medicare Post-Acute Services Authorization Requests	12/12/2025
62	Rochester Conversion Factor Table for Physical Therapy, Occupational Therapy, and Speech Therapy	12/19/2025
63	Buffalo Conversion Factor Table for Physical Therapy, Occupational Therapy, and Speech Therapy	12/19/2025
64	Medical Policy Updates Effective February 1, 2026	12/19/2025
65	Pharmaceutical Policy Updates Effective February 1, 2026	12/19/2025
66	Formulary Updates Effective February 1, 2026	12/19/2025
67	MVP Announces Additional Coverage Options for Members in New York State	12/22/2025
68	Confirmation Needed: Your Provider Demographic Information	12/24/2025
69	Postponement of Avalon Healthcare Solutions Precision Genetic Testing Management Policy Implementation	12/30/2025

1	DualAccess Cost Share & Training Update	1/1/2024
2	MVP Scheduled System Downtime	1/8/2024
3	HEDIS Operations Deadlines and Updates	1/11/2024
4	Location Value Code Guidance and CHCBS Rural Rates	1/17/2024
5	School-Based Mental Health (SBMH) Clinic Rate Enhancement	1/17/2024
6	eviCore Healthcare updates	1/18/2024
7	Crisis Intervention Authority and Reimbursement Changes	1/31/2024
8	Children’s Crisis Intervention SPA Guidance Update	2/19/2024
9	Pharmacy Formulary Updates Effective April 1, 2024	2/21/2024
10	Pharmaceutical Policy Updates Effective April 1, 2024	2/21/2024
11	Medical Policy Updates Effective April 1, 2024	2/21/2024
12	Providers Impacted by Change Healthcare Network Outage	2/23/2024
13	Healthy Practices Is Now Digital	2/27/2024
14	Crisis Intervention SPA Changes	2/27/2024
15	Prior Authorization Update: eviCore Healthcare	2/29/2024
16	Change Healthcare Network Outage - UPDATE	3/7/2024
17	Confirmation Needed: Your Provider Demographic Information	3/28/2024
18	MVP Outreach Campaign to Verify Your Information	4/24/2024
19	Healthy Practices is Now Available	4/25/2024
20	Medical Policy Updates Effective June 1, 2024	4/26/2024
21	Pharmaceutical Policy Updates Effective June 1, 2024	4/26/2024
22	Pharmacy Formulary Updates Effective June 1, 2024	4/26/2024
23	Laboratory Benefit Services to be Managed by Avalon Healthcare Solutions	5/1/2024
24	New York State Essential Plan Coverage Expansion	5/2/2024
25	Important Information from MVP HEDIS Operations	5/9/2024
26	Annual Review of Clinical Criteria	6/6/2024
27	Medical Policy Updates Effective August 1, 2024	7/1/2024
28	Pharmaceutical Policy Updates Effective August 1, 2024	7/1/2024
29	Pharmacy Formulary Updates Effective August 1, 2024	7/1/2024
30	Confirmation Needed: Your Provider Demographic Information	7/2/2024
31	Execution of Clinical Criteria	7/11/2024
32	Healthy Practices Newsletter is Now Available	7/16/2024
33	Action Required—MVP At-Home Collection Kits Program	7/22/2024
34	Avalon Laboratory Policies Delayed	8/9/2024
35	Laboratory Policy Updates Effective September 15, 2024	8/16/2024
36	Pharmaceutical Policy Updates Effective October 1, 2024	8/26/2024
37	Pharmacy Formulary Updates Effective October 1, 2024	8/26/2024
38	Medical Policy Updates Effective October 1, 2024	8/26/2024
39	Opioid Treatment Bundled Services Billing Update (Action Required)	8/28/2024
40	Scheduled Security Update of MVP Provider Online Accounts	9/9/2024
41	MVP Scheduled System Downtime	9/13/2024
42	Update Your MVP Provider Online Account	9/16/2024
43	Updated Information Regarding Children in Foster Care	9/24/2024
44	UVM Health Advantage Plan Will No Longer Be Offered in Vermont Starting January 1, 2025	9/26/2024
45	Healthy Practices Newsletter is Now Available	10/22/2024
46	Pharmaceutical Policy Updates Effective December 1, 2024	10/30/2024
47	Pharmacy Formulary Updates Effective December 1, 2024	10/30/2024
48	Medical Policy Updates Effective December 1, 2024	10/30/2024
49	Action Required: Electronic Visit Verification (EVV) Attestation	10/31/2024
50	Provider and Payment Policy Updates Effective January 1, 2025	11/1/2021
51	Confirmation Needed: Your Provider Demographic Information	11/22/2024
52	Medical Policy Updates Effective February 1, 2025	11/26/2024
53	Pharmaceutical Policy Updates Effective January 1, 2025	11/26/2024
54	Pharmacy Formulary Updates Effective January 1, 2025	11/26/2024
55	Laboratory Policy Updates Effective February 1, 2025	11/27/2024
56	HEDIS Operations Deadlines and Updates	12/4/2024
57	Optum to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments	12/10/2024
58	Reminder: Electronic Visit Verification (EVV) Attestation	12/12/2024
59	Pharmaceutical Policy Updates Effective February 1, 2025	12/19/2024
60	Changes to Medical and Pharmaceutical Policy Access	12/23/2024
61	Adult and Youth Assertive Community Treatment (ACT) Redesign Billing Changes	12/24/2024

1	Changes to Respite Telehealth Services Update	1/5/2023
2	Changes to Billing and Payment of Evaluation and Management for Preventive and Sick Visits	2/1/2023
3	Important Updates for Licensed Mental Health Counselor and Licensed Marriage and Family Therapist Services	2/13/2023
4	Medical Policy Updates Effective April1, 2023	2/28/2023
5	Pharmacy Formulary Updates Effective April 1, 2023	2/28/2023
6	Pharmaceutical Policies Updates Effective April 1, 2023	2/28/2023
7	Medicaid Pharmacy Benefit Transitioning to New York State NYRx Medicaid Pharmacy Plan	3/2/2023
8	Claims Submission Update	3/3/2023
9	Pharmaceutical Policies Updates Effective April 1, 2023	3/6/2023
10	Online Provider Demographic Information Review Request	3/30/2023
11	Prior Authorization Updates	4/18/2023
12	Action Required: eMedNY/MMIS Annual Certification Statement	4/19/2023
13	Pharmaceutical Policies Updates Effective June 1, 2023	4/25/2023
14	Medical Policy Updates Effective June 1, 2023	4/25/2023
15	Pharmacy Formulary Updates Effective June 1, 2023	4/24/2023
16	Annual Review of Clinical Criteria	5/3/2023
18b	Recertifications Have Resumed for Medicaid, HARP, CHP, and EP	5/8/2023
19	COVID-19 PHE Unwind announcement	5/11/2023
20	Provider Survey Reminder	5/16/2023
22	Prior Authorization Update: Magellan Health	5/25/2023
23	Updated Payment Rules for Trabecular Bone Scans and Bone Density Studies	6/14/2023
24	MVP Expands Network Coverage in New York State	6/14/2023
25	Pharmacy Formulary Updates Effective August 1, 2023	6/27/2023
26	Pharmaceutical Policies Updates Effective August 1, 2023	6/27/2023
27	Medical Policy Updates Effective August 1, 2023	6/27/2023
28	Online Provider Demographic Information Review Request	6/30/2023
29	MVP Health Care Offers Integrated Benefits D-SNP Plan in New York	7/5/2023
30	Execution of Clinical Criteria	7/6/2023
31	Pharmaceutical Policies Updates Effective September 1, 2023	7/27/2023
32	Pharmacy Formulary Updates Effective September 1, 2023	7/27/2023
33	Gaps In Care Webinar to be Offered in September	7/28/2023
34	Medical policies Effective October 1, 2023	8/24/2023
35	Pharmacy Formulary Updates effective October 1, 2023	8/24/2023
36	Pharmaceutical Polices Updates Effective October 1, 2023	8/24/2023
37	Register for the MVP Gaps In Care Webinar	8/29/2023
38	Important Updates for Article 29-I VFCA Health Facilities	9/15/2023
39	GLP-1 Receptor Agonist Coverage Update	9/29/2023
40	Online Provider Demographic Information Review Request	10/2/2023
41	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments (New York)	10/3/2023
41	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments (Vermont)	10/3/2023
42	Changes to Medical and Pharmaceutical Policy Access	10/4/2023
43	COVID-19 Vaccination Coverage Update	10/20/2023
44	Pharmaceutical Polices Updates Effective December 1, 2023	10/26/2023
45	Medical Policy Updates Effective December 1, 2023	10/26/2023
46	Pharmacy Formulary Updates Effective December 1, 2023	10/26/2023
47	New Prescribing Provider Quality Incentive Program	10/31/2023
48	MVP Partners with LetsGetChecked to Offer Medicaid Members At-Home Kits to Complete Preventive Screenings	11/3/2023
49	Updates Regarding Care for Children in Foster Care	11/9/2023
50	Location Value Code Billing Change for CHCBS and CFTSS	11/21/2023
51	Pharmacy Formulary Updates Effective January 1, 2024	11/30/2023
52	Pharmaceutical Polices Updates Effective January 1, 2024	11/30/2023
53	Vermont Uniform Medical Prior Authorization Form Update	12/1/2023
54	Optum Health Care Solutions to Administer Prior Authorization Services for Outpatient Medical Oncology Treatments	12/6/2023
55	Home Health Prior Authorization and Concurrent Review Process Changes	12/8/2023
57	Confirmation Needed: Your Provider Demographic Information	12/20/2023
58	Rochester Conversion Factor Table	12/20/2023
59	Buffalo Conversion Factor Table	12/20/2023
60	Pharmaceutical Policies Updates Effective February 1, 2024	12/28/2023
61	Pharmacy Formulary Updates Effective February 1, 2024	12/28/2023
62	Medical Policy Updates Effective February 1, 2024	12/28/2023

1	New Pharmacy Electronic Prior Authorization Process	1/4/2022
2	Online Provider Demographic Information Review Request	1/7/2022
3	Prior Authorization and Concurrent Review for Post-Acute Care Services	1/11/2022
4	Community Oriented Recovery and Empowerment (CORE) Services	1/13/2022
5	Medicare Reimbursement of COVID-19 Vaccines and Antibody Treatment	1/14/2022
6	Children/Youth in Foster Care	1/24/2022
7	MVP Medicaid SGLT2 Coverage	1/31/2022
8	COVID-19 Vaccine Coding and Billing Reminder – Vermont Only	2/18/2022
9	Updated Contact Information for Durable Medical Equipment Requests	2/24/2022
10	Medical Policy Updates Effective April 1, 2022	2/25/2022
11	Pharmacy Formulary Updates Effective April 1, 2022	2/25/2022
12	Pharmaceutical Policies Updates Effective April 1, 2022	2/25/2022
13	Updated New York State Regulations for Medicaid Opioid Dependence Agents and Opioid Antagonists	2/28/2022
14	KX Modifier Claims Processing	3/18/2022
15	Online Provider Demographic Information Review Request	4/1/2022
16	Claims Submission Update	4/4/2022
17	Pharmacy Formulary Updates Effective June 1, 2022	4/28/2022
18	Pharmaceutical Policies Updates Effective June 1, 2022	4/28/2022
19	Medical Policy Updates Effective June 1, 2022	4/28/2022
20	Changes to Billing and Payment of Implantable Devices	5/4/2022
21	Virtual Care and COVID-19 Treatment Cost-Share Update	5/4/2022
22	Claims Submission Update	5/25/2022
23	Annual Review of Clinical Criteria	6/1/2022
24	Improving Medical Record Submissions to MVP For Quality Gaps in Care Processing	6/3/2022
25	Pharmacy Formulary Updates Effective August 1, 2022	6/28/2022
26	Pharmaceutical Policies Updates Effective August 1, 2022	6/28/2022
27	Medical Policy Updates Effective August 1, 2022	6/28/2022
28	Online Provider Demographic Information Review Request	7/6/2022
29	Claims Submission Update	7/7/2022
30	Claims Submission Update	7/7/2022
32	Execution of Clinical Criteria	8/9/2022
33	BiPAP and CPAP Prior Authorization Updates	8/25/2022
34	Changes to MVP Payment Summaries	8/29/2022
35	Pharmacy Formulary Updates Effective October 1, 2022	8/30/2022
36	Pharmaceutical Policies Updates Effective October 1, 2022	8/30/2022
37	Medical Policy Updates Effective October 1, 2022	8/30/2022
38	Billing Changes for Dispensing Medication	9/21/2022
39	Online Provider Demographic Information Review Request	9/29/2022
40	Claims Submission Update	10/26/2022
41	Pharmaceutical Policies Updates Effective December 1, 2022	10/27/2022
42	Pharmacy Formulary Updates Effective December 1, 2022	10/27/2022
43	Medical Policy Updates Effective December 1, 2022	10/27/2022
44	Applied Behavioral Analysis (ABA) Government Program Benefit Update	11/8/2022
45	Dual Special Needs Program (D-SNP) ACTION REQUIRED: Complete Training	11/16/2022
46	Medical Policy Updates Effective January 1, 2023	11/23/2022
47	Pharmaceutical Policies Updates Effective January 1, 2023	11/23/2022
48	Pharmacy Formulary Updates Effective January 1, 2023	11/23/2022
49	2022-49-mvp-health-care-hmo-plans-awarded-5-stars	11/29/2022
50	Expanded Services Available for Child Health Plus (CHP) Members Effective January 1, 2023	12/16/2022

1A	Utilization Management Changes Due to COVID-19, Effective December 23, 2020 through February 21, 2021	01/12/21
2	COVID-19 Vaccine Reimbursement and Coding	01/11/21
3	Important Developmental and Autism Screening Updates for Young Children	02/08/21
4	Medical Policy Update: Applied Behavior Analysis (ABA)	02/15/21
5	Medical Policy Updates Effective April 1, 2021	02/25/21
6	Pharmaceutical Policies Updates Effective April 1, 2021	02/25/21
7	Pharmacy Formulary Updates Effective April 1, 2021	02/25/21
8	MVP to Resume All Utilization Management Prior Authorization and Concurrent Review Programs Effective March 1, 2021	02/26/21
9	New Payment Policy: Robotic and Computer Assisted Surgery	03/01/21
10	Update for Applied Behavior Analysis Indirect Services	03/12/21
11	Medicaid Pharmacy Benefit Transitioning to New York State Medicaid Fee-for-Service	03/12/21
12	Updated COVID-19 Vaccine Reimbursement and Coding – New York Only	03/18/21
13	Updated COVID-19 Vaccine Reimbursement and Coding – Vermont Only	03/18/21
14	Online Provider Demographic Information Review Request	03/26/21
15	Evaluation and Management Payment Policy Update: Physician Diagnostic, Therapeutic and Preventive Injections	04/02/21
16	COVID-19 Update – April 5, 2021	04/05/21
17	Project TEACH Educational Webinar	04/08/21
18	Transition of Children in Voluntary Foster Care Into Medicaid Managed Care	04/09/21
19	Pharmacy Formulary Updates Effective June 1, 2021	04/29/21
20	Pharmaceutical Policies Updates Effective June 1, 2021	04/29/21
21	Medical Policy Updates Effective June 1, 2021	04/29/21
22	Utilization Management Updates	04/30/21
23	Medicaid Pharmacy Benefit Transition to New York State Medicaid Fee-for-Service Delayed	05/07/21
24	Important Newborn Hearing Information	06/04/21
25	Updates to Cost-Share (NY Only)	06/09/21
26	Payment Policy Updates Effective September 15, 2021	06/19/21
27	Online Provider Demographic Information Review Request	06/24/21
28	Annual Review of Clinical Criteria	06/25/21
29	Voluntary Foster Care: Medication Transition	06/29/21
30	Virtual Care and COVID-19 Treatment Cost-Share Update	07/02/21
31	Billing Procedure Code Change for Diabetic Supplies – Vermont Only	07/07/21
32	Pharmaceutical Policies Updates Effective September 1, 2021	07/19/21
33	Pharmacy Formulary Updates Effective September 1, 2021	07/19/21
34	Medical Policy Updates Effective August 1, 2021	07/19/21
35	New York State Medication-Assisted Treatment Formulary Change	07/27/21
36	Applied Behavior Analysis for Medicaid Managed Care Plans	08/26/21
37	Prior Authorization Change for Tufts Health Plan Members	08/26/21
38	Pharmaceutical Policy Updates Effective October 1, 2021	08/27/21
39	Pharmacy Formulary Updates Effective October 1, 2021	08/27/21
40	Medical Policy Updates Effective October 1, 2021	08/27/21
41	Applied Behavior Analysis for Medicaid Managed Care Plans	08/31/21
42	Execution of Clinical Criteria	09/23/21
43	MVP Scheduled System Downtime	09/24/21
44	Online Provider Demographic Information Review Request	10/01/21
45	Update to Applied Behavior Analysis Services	10/05/21
46	Regarding Certification for Utilization Pause for Prior Authorization and Concurrent Review, Acute Care and Post Acute Care Services	10/13/21
47	MVP is Requesting Main Group Contact Information	10/18/21
48	Pharmaceutical Policies Updates Effective December 1, 2021	10/28/21
49	Pharmacy Formulary Updates Effective December 1, 2021	10/28/21
50	Medical Policy Updates Effective December 1, 2021	10/28/21
51	MVP Health Care Announces New UVM Health Advantage Plans	11/01/21
52	New Pharmacy Electronic Prior Authorization Process to Launch in December	11/08/21
53	Pharmaceutical Policies Updates Effective January 1, 2022	11/29/21
54	Pharmacy Formulary Updates Effective January 1, 2022	11/29/21
55	Radiology Prior Authorization Updates	11/30/21
56	Buffalo Conversion Factor Table	12/01/21
57	Rochester Conversion Factor Table	12/01/21
58	Improving Medical Record Transmission	12/03/21
59	New Pharmacy Electronic Prior Authorization Process Now Available	12/06/21
60	Pharmacy Formulary Updates Effective February 1, 2022	12/16/21
61	Pharmaceutical Policies Updates Effective February 1, 2022	12/16/21
62	Medical Policy Updates Effective February 1, 2022	12/16/21
63	Notifying MVP Health Care of New Tax Identification Numbers (TIN)	12/22/21
64	Audio-Only Coding and Reimbursement Updates for Vermont Providers	12/29/21
65	Prior Authorization Updates for Durable Medical Equipment (DME)	12/30/21

1	IVF Pharmacy Policy Updates Effective	01/01/20
2	Clinical Guidelines for HIV Pre-Exposure Prophylaxis	01/31/20
3	Pharmacy Formulary Updates Effective 1/1/2020	01/31/20
4	Services Not Separately Reimbursed	01/31/20
5	Epidural Limitations	01/31/20
6	Coronavirus Update (as of 2/6/20)	02/06/20
7	Payment Policy Updates Effective 1/1/2020	02/28/20
8	Influenca Testing Reimbursement	02/18/20
9	Medical Policy Updates Effective 4/1/2020	02/24/20
10	Pharmacy Policy Updates Effective 4/1/2020	02/24/20
11	Formulary Updates Effective 4/1/2020	02/24/20
12	HPV Vaccinations	03/04/20
14	Coronavirus Disease 2019 (COVID-19) Update	03/09/20
15	Coding of COVID-19 Update	03/13/20
16	Change in Behavioral Health Prior Authorization Requirements	03/17/20
17	MVP Health Care Launches myERnow, Virtual ER Telemedicine Service	03/18/20
18	Telemedicine Updates	03/18/20
19	COVID-19 Update (as of 3/19/2020)	03/19/20
20	Claims Status Process	03/20/20
21	COVID-19 Update (as of 3/20/2020)	03/20/20
22	COVID-19 Updates for Physical Therapists, Occupational Therapists, and Speech Therapists (as of 3/20/2020)	03/20/20
23	COVID-19 Utilization Management Updates (as of 3/24/2020)	03/24/20
24	COVID-19 Update (as of 3/27/2020)	03/27/20
25	COVID-19 Medicare Update (as of 3/27/2020)	03/27/20
26	COVID-19 Vermont Update (as of 3/30/2020)	03/30/20
27	Online Provider Demographic Information Review Request	03/31/20
28	COVID-19 Update (as of 4/8/2020)	04/08/20
29	Utilization Management Changes Due to COVID-19	04/09/20
30	MVP Introduces New Online Provider Search Tool	04/13/20
31	Pharmacy Formulary Updates Effective June 1, 2020	04/21/20
32	Pharmaceutical Policy Updates Effective June 1, 2020	04/21/20
33	Medical Policy Updates Effective June 1, 2020	04/21/20
34	Colorectal Screening for MVP Vermont Commercial Members	04/23/20
35	Durable Medical Equipment (DME) Prior Authorization Updates	04/24/20
36NY	New York COVID-19 Update as of May 7, 2020	05/07/20
36VT	Vermont COVID-19 Update as of May 7, 2020	05/27/20
37	Claims Status Update (as of 5/21/20)	05/21/20
38	Annual Review of Clinical Criteria	05/29/20
39	Diagnosis Matching Edits Policy Update (as of 5/29/20)	05/29/20
40.1	Elective Procedures Prior Authorization Requirement Update (as of 6/2/20)	06/02/20
41	Children’s Uniform Clinical Network Provider Training	06/03/20
42	Provider Service Upgrades Interactive Voice Response (IVR) System	06/18/20
43	COVID-19 Update – Behavioral Health Cost-Share (as of 6/15/20)	06/15/20
44	Acute Care and Post-Acute Care Services Update (as of 6/16/20)	06/16/20
45	Pharmacy Formulary updates effective August 1, 2020	06/25/20
46	Pharmaceutical Policy updates effective August 1, 2020	06/25/20
47	Default Pricing Change for Reimbursement effective October 1, 2020	06/30/20
48	Medical Policy updates effective August 1, 2020	06/25/20
49	Online Provider Demographic Information Review Request	06/29/20
50	COVID-19 Update as of July 2, 2020	07/02/20
51	Scheduled System Downtime	07/09/20
52	Payment Policy Updates as of July 15, 2020	07/15/20
53	System Downtime Scheduled for July 17, 2020 Postponed	07/15/20
54	Behavioral Health Services Update: Utilization Management Changes Effective August 19, 2020	07/20/20
55	Execution of Clinical Criteria Effective August 1, 2020	07/22/20
56	Pharmacy Formulary Updates Effective September 1, 2020	07/30/20
57	Pharmaceutical Policies Updates Effective September 1, 2020	07/30/20
58	System Upgrade with Scheduled Downtime August 20, 2020	08/20/20
59	Closing Gaps-In-Care Utilizing Telemedicine Services	08/21/20
62	Reduce the Burden of Gaps in Care Reporting	09/02/20
63	Medical Policy Updates Effective October 1, 2020	09/03/20
64	COVID-19 Update – September 4, 2020	09/04/20
65	Personal Protective Equipment Update (as of 9/9/20)	09/09/20
66	Atrial Fibrillation Ablation, Catheter-Based Medical Policy	09/29/20
68	Arthroscopic, Endoscopic, and other Non-Endoscopic Scope Procedures Payment Policy	10/01/20
69	Pharmacy Formulary Updates Effective December 1, 2020	10/28/20
70	Pharmaceutical Policies Updates Effective December 1, 2020	10/28/20
71	Medical Policy Updates Effective December 1, 2020	10/28/20
72	Clinical Guidelines for HIV Pre-Exposure Prophylaxis	10/28/20
73	COVID-19 Testing Update – November 11, 2020	11/11/20
74	Multiple Procedure Reduction on the Technical Component of Diagnostic Cardiovascular and Ophthalmology Procedures Payment Policy	11/05/20
75	New York State Delays Medication-Assisted Treatment Formulary Change	11/12/20
76	Change to Pharmacy Networks	11/19/20
77	Medical Policy Update Effective January 1, 2021	11/24/20
78	Pharmaceutical Policies Updates Effective January 1, 2021	11/24/20
79	Pharmacy Formulary Updates Effective January 1, 2021	11/24/20
80	Important Changes from MVP Health Care® (MVP) Regarding Prior Authorization for High Tech Radiology	11/30/20
81	MVP Health Care® (MVP) Rochester Conversion Factor Table Effective as of January 1, 2021 Date of Service	12/01/20
82	MVP Health Care® (MVP) Buffalo Conversion Factor Table Effective as of January 1, 2021 Date of Service	12/01/20
83	New naviHealth Home Health Approval Processes	12/07/20
84	Retrieval of Medical Records from Third-Party Vendors	12/08/20
85	MVP Prior Authorization for Musculoskeletal Surgery Updates	12/18/20
86	MVP Prior Authorization for Radiology Updates	12/18/20
87	Skilled Nursing Home Utilization Management Changes Due to COVID-19	12/21/20
88	Actions to take for MVP Health Care® (MVP) Medicare Members	12/22/20
89	Pharmacy Formulary Updates Effective February 1, 2021	12/23/20
90	Pharmaceutical Policies Updates Effective February 1, 2021	12/23/20
91	MVP Health Care Code of Ethics and Business Conduct Summary	12/28/20
92	Online Provider Demographic Information Review Request	12/30/20

1	New Medicare Opiate Edits for 2019	01/02/19
2	Help Us Fight the Opioid Epidemic	01/03/19
3	MVP Health Care expands its collaboration with Vital Decisions	01/30/19
4	Provide Opioid Feedback Before 2/22 Deadline	02/08/19
5	Pharmaceutical policies available	02/21/9
6	Pharmacy Formulary Updates effective 4/1/2019	02/26/19
7	Required Authorizations for Radiology Services	02/27/19
8	naviHealth Peer-To-Peer Process Enhancements	03/12/19
9	Medical Policies available	03/13/19
10	Centers for Medicare & Medicaid Services (CMS) Health Outcome Surveys	03/14/19
11	Online Provider Demographic Information Review Request	03/28/19
12	Pharmaceutical Policies Available	04/25/19
13	Pharmacy Formulary Updates Effective 6/1/2019	04/26/19
14	Nationally Renowned Pediatric Oncologist Joins MVP Health Care	04/29/19
15	Payment Policy Updates Effective June 1, 2019	04/30/19
16	Medical Policies available for Providers	05/01/19
17	Annual Review of Clinical Criteria	05/02/19
18	Medicare Advantage Plans Introduce Condition Specific Benefits	05/29/19
19	Payment Policy Updates: Services Not Reimbursed	05/30/19
21	MVP Health Care Announces Next CEO, Christopher Del Vecchio	06/12/19
22	Pharmacy Formulary Updates Effective 8/1/2019	06/19/19
23	Children and Family Treatment and Support Services Available as of July 1, 2019	06/20/19
24	Pharmaceutical Policies Available	06/21/19
25	Online Provider Demographic Information Review Request	06/25/19
26	Ongoing Measles Outbreak and Opioid Update	06/27/19
27	MVP Payment Policy Update: After-Hours Services	07/09/19
28	MVP Health Care to Transform Care Delivery Through New Integrated Health Initiative	07/10/19
29	Execution of Clinical Criteria	07/12/19
30	MVP Website Security Update, Provider Online Access	07/15/19
31	Pharmaceutical Policies Available	07/23/19
32	Pharmacy Formulary Updates Effective 9/1/2019	07/24/19
33	After-Hours Services Policy Clarification/Newsletter Update	07/29/19
34	Pharmacy Formulary Updates Effective 10/1/2019	08/19/19
35	Pharmaceutical Policies Available	08/20/19
36	Children’s Home and Community Based Services	08/30/19
37	Medical Policies Available	09/04/19
38	Important Lead Screening Updates for Young Children	09/11/19
43	Payment Policy Clarification: Services Not Reimbursed	09/24/19
39	Online Provider Demographic Information Review Request	09/24/19
40	Global Edit Updates	09/26/19
42	Medicaid Managed Care: Infertility Benefits Update	09/27/19
41	Important Developmental Screening Updates for Young Children	09/27/19
44	Updated HPV Vaccination Recommendations for U.S. Adults	10/16/19
46	Pharmaceutical Policies Available	10/22/19
45	Pharmacy Formulary Updates Effective 12/1/2019	10/22/19
50	IVF Pharmacy Policy Updates Effective 01/01/2020	11/18/19
49	Pharmaceutical Policies Available	11/18/19
48	Pharmacy Formulary Updates Effective 1/1/2020	11/18/19
51	Important Newborn Hearing Information	11/26/19
52	New Medicaid Managed Care Benefits	11/27/19
56	New for 2020: Free Meal Delivery After Inpatient Hospitalization	12/09/19
55	Pharmacy Tips and Best Practices	12/09/19
58	Pharmacy Formulary Updates	12/23/19
57	Pharmaceutical Policies Available	12/23/19
60	Pediatric Lead Testing Program	12/24/19
59	Online Provider Demographic Information Review Request	12/24/19
62	MVP Health Care Code of Ethics and Business Conduct Summary	12/31/19

1	Pharmaceutical Policies Available	01/05/18
2	CMS Medicare Benefits and Beneficiary Protections	01/10/18
3	1/1/18 Insulin Changes	01/10/18
5	MVP Health Care Musculoskeletal Management Program Provider Education Webinars	01/17/18
6	Improving Perinatal Care for Medicaid Members	01/18/18
7	Musculoskeletal Management Program	02/15/18
8	CMS Medicare Benefits and Beneficiary Protections	02/16/18
9	Pharm Policies Available	03/01/18
10	Pharm Formulary Updates	03/02/18
11	Musculoskeletal Management Program	03/16/18
12	CMS Medicare Benefits and Beneficiary Protections	03/16/18
13	Online Provider Demographic Information Review Request	03/29/18
14	CMS Medicare Benefits and Beneficiary Protections	04/13/18
15	Annual Review of Clinical Criteria	04/27/18
16	Pharm Policies Available	04/30/18
17	Pharm Formulary Updates	05/01/18
18	Online Provider Change of Information Form Available May 15	05/07/18
19	MVP Gaps in Care Reports (CNY); MVP Gaps in Care Reports (all others)	05/08/18
21	CMS Medicare Benefits and Beneficiary Protections	05/23/18
20	Surgical Supplies Reimbursement Policy Updates	05/31/18
22	CMS Medicare Benefits and Beneficiary Protections	06/14/18
23	Notice of discontinue of provider bonus incentives	06/15/18
24	Online Provider Change of Information Form – Required for Use July 1, 2018	06/25/18
25	Online Provider Demographic Information Review Request	06/26/18
26	Change in Prior Authorization Facility Based Sleep Studies Effective October 1, 2018	06/28/18
27	Execution of Clinical Criteria	06/29/18
28	Vermont TeleHealth Billing and Reimbursement	07/02/18
29	CMS Medicare Benefits and Beneficiary Protections	07/06/18
30	Updated Provider Change and Patient Reassignment Request Form Now Available	08/09/18
31	Pharmacy Policy Updates	08/20/18
32	Pharmacy Formulary Updates, effective 8/1/18	08/16/18
33	Urgent Care Payment Policy	08/30/18
34	CMS Medicare Benefits and Beneficiary Protections	09/17/18
35	Pharmacy Formulary Updates, effective 9/1/18	09/20/18
36	MVP Health Care, Inc. Code of Ethics and Business Conduct Summary	09/21/18
37	Online Provider Demographic Information Review Request	09/25/18
39	Pharmaceutical policy updates available	09/25/18
40	Correction to Payment Policy Updates ? Effective 1/1/19	09/30/18
41	Musculoskeletal Management Program	09/28/18
42	Pharmacy Formulary Updates Effective 11/1/2018	10/29/18
43	Pharmaceutical Policies available for providers	10/30/18
44	Office Consultation for Screening Colonoscopy	11/01/18
46	Medical Policy updates available	11/06/18
47	Diagnosis Matching Edits Policy Update	11/15/18
48	New Children and Family Treatment and Support Services (CFTSS) Available Starting January 1, 2019	11/29/18
49	Pharmaceutical Policy Updates	12/04/18
50	Pharmacy Formulary Updates Effective 12/1/2018	12/05/18
52	Pharmacy Formulary Updates Effective 1/1/19	12/21/18
53	Pharmaceutical Policies available for Providers	12/20/18
54	Credentialing Update for MVP Providers	12/26/18
55	Online Provider Demographic Information Review Request	12/28/18

Resources

Forms

Pharmacy

Provider Onboarding

Quality Programs

Find a Doctor

Reference Library

Reference Library Home

Provider and Payment Policies

Medical Policies

Pharmacy Policies

Education and Training

Communications Center

Communications Center Home

Formulary and Policy Updates

Important Updates

Process Updates

Gaps in Care

Resources

Forms

Pharmacy

Provider Onboarding

Quality Programs

Find a Doctor

Reference Library

Reference Library Home

Provider and Payment Policies

Medical Policies

Pharmacy Policies

Education and Training

Communications Center

Communications Center Home

Formulary and Policy Updates

Important Updates

Process Updates

Gaps in Care

FastFaxes from MVP Health Care

Who We Are

Explore Plans

Sign In

Update Your Demographics

Resources

Reference Library

Communications Center

Update Your Demographics

Resources

Reference Library

Communications Center

FastFaxes from MVP Health Care

2025

2024

2023

2022

2021

2020

2019

2018

Who We Are

Explore Plans

Sign In