We release communications to in-network providers about changes to health plan procedures, policies and benefits, as well as information about larger initiatives. This page lists some of our issued notifications for reference.
WellFirst Health is transitioning the Claim Appeals application in the Provider Portal.
Issued: August 2022
Audience: All in-network providers
Effective date: 8/24/2022
View new claim appeals portal application
Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/2022
FDA approved drugs that are new to the market will not be covered until they are reviewed and approved by P&T Committee.
Issued: September 2021
Audience: All in-network providers
Effective date: 12/1/2021
Audience: all in-network providers
For pharmacy updates issued on and after April 1, 2022, see the medical and drug policy updates listed on this page.
Audience: All in-network providers
ALDURAZYME-laronidase, ARANESP-darbepoetin alpha, ELAPRASE-idursulfase, ELELYSO-taliglucerase alfa, Epoetin Alfa Products, NAGLAZYME-galsulfase, VIMIZIM-elosulfase, and retired policy
Issued: February 2022
Effective date: 6/1/2022
Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies
Issued: February 2022
Effective date: 5/1/2022
INFUGEM-gemcitabine, Parenteral Iron products and retired policy
Issued: December 2021
Effective date: 4/1/2022
CRYSVITA (burosumab)
Also includes changes to fax and phone numbers on Medical Benefit Drug Prior Authorization Forms and the new Pharmacy and Therapeutics Committee review process.
Issued: December 2021
Effective date: 3/1/2022
Medicare Part B Step Therapy, ORENCIA (abatacept-IV) SIMPONI ARIA (golimumab), FLOLAN-epoprostenol-REMODULIN-treprostinil and New Drug Policies for Medicare Advantage
Issued: October 2021
Audience: All in-network providers
Effective date: 2/1/2022 & 4/1/2022
Medically Administered Oncology Products, Pegfilgrastim Products, PROLIA, XGEVA and Retired Policies
Issued: October 2021
Audience: All in-network providers
Effective date: 1/1/2022