2025 News Archive

Legislative Changes
Provider Information on COVID-19 Coverage
Blue Review newsletter

12/24/25 Prior Authorization Changes for Some Government Program and Commercial Members
12/23/25 Medical Record Collection for Commercial Members Starts in February 2026
12/23/25 Prior Authorization Changes for Medicare Advantage Members, Effective Jan. 1, 2026
12/23/25 See Changes to Coverage for Breast Cancer Screening
12/22/25 Marketplace Members Rate Satisfaction with Providers
12/22/25 Clinical Payment and Coding Policy Updates
12/17/25 Update Your Records for New Blue Cross Group Medicare Advantage Open Access (PPO)^SM Members 
12/15/25 Medical Records Collection for Federal Employee Program^® Begins in February
12/09/25 Provide Records to Support Quality Care for Medicare Advantage Members
12/05/25 Remind Our Members About Cervical and Breast Cancer Screenings
12/04/25 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
12/01/25 We’re Renaming Clinical Payment and Coding Policies to Reimbursement Policies
11/26/25 Enhanced Diagnosis Claim Edits to Follow CMS Guidelines
11/25/25 Remember to use Proper Coding for Evaluation and Management Services, Modifiers and Oncology Drugs and Services for Medicare Claims
11/24/25 Clinical Payment and Coding Policy Updates
11/24/25 Prior Authorization Changes for Some Government Program Members, Effective Jan. 1, 2026
11/21/25 BlueApprovR^SM To Accept Concurrent Reviews and Extensions for Behavioral Health Services: Attend a Training  
11/17/25 Update: Paid Claims Editing To Be Enhanced in April 2026 for Medicare Advantage Members
11/14/25 Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)^SM 2024 Program Summary
11/13/25 Earn Continuing Education Credit: Webinar on Autism Spectrum Disorder
11/12/25 Keep Your Record ID Active To Prevent Network Termination 
11/11/25 See Updates to Behavioral Health Clinical Practice Guidelines
11/06/25 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2026 – Part 1
10/31/25 Prior Authorization Changes for Some Commercial Members, Effective Jan. 1, 2026
10/29/25 Clinical Payment and Coding Policy Updates
10/22/25 Availity^® Essentials Claim Status Tool Updates
10/21/25 Updates on Managing Your Data in Availity^® Essentials
10/14/25 Verify Your Directory Information Every 90 Days 
10/09/25 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2025 – Part 2
10/03/25 Encourage Annual Eye Exams for Members with Diabetes
10/01/25 Prior Authorization Changes for Some Commercial and Government Program Members, Effective Jan. 1, 2026
9/25/25 New Coding Policy for Psychiatry/Psychotherapy Services for Professional Providers
9/24/25 Learn What Members Say They Want from Their Health Care Professionals
9/24/25 We’re Expanding Our Laboratory Benefit Management Program, Effective Jan. 1, 2026  
9/23/25 Ask Members to Complete a Depression Screening
9/23/25 Clinical Payment and Coding Policy Updates
9/23/25 Member Benefit Coverage for Viscosupplementation for Osteoarthritis will End Jan. 1, 2026
9/22/25 PEAQ^SM Physician Performance Insight Reports Are Now Available
9/22/25 We’re Reducing Prior Authorization Response Times for Medicare Members
9/19/25 Support Care Coordination after Hospital Discharges
9/18/25 Access New Resource on Quality Measures in Availity^® Essentials
9/17/25 Look for Your Medicare Advantage Access and Availability Survey
9/12/25 Encourage Routine Screening to Detect Breast Cancer Early
9/11/25 Encourage Our Members to Adhere to Statin Therapy As Prescribed
9/03/25 Discuss the Flu Vaccine with Our Members
9/02/25 Changes to Medical Policies
9/02/25 Prior Authorization Changes for Some Commercial Members, Effective Oct. 1, 2025
8/27/25 Watch for Updated Out-of-area Member ID Cards with No Suitcase Logo
8/25/25 Clinical Payment and Coding Policy Updates
8/21/25 Look for an Amendment to Your Provider Agreement, Effective Dec. 1, 2025
8/20/25 Avoid Antibiotics for Acute Bronchitis and Other Viruses
8/15/25 Five New Claims Editing Rules will be Implemented November 2025
8/13/25 Use Shared Decision-Making Aids to Help Guide Care Choices
8/11/25 Consider Behavioral Health Evaluations During Hospital Stays
8/08/25 Verify Your Information in Statewide Provider Directory Pilot for Qualified Health Plans
8/05/25 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2025 – Part 1
7/29/25 Update: Out-of-State Care Beyond Contiguous Counties Waiver Review
7/29/25 Clinical Payment and Coding Policy Updates
7/25/25 Provide Records to Support Risk Adjustment Data Validation Audit
7/24/25 ICD-10-CM Z Codes Help Us Track Members’ Social Needs
7/24/25 Update Regarding Recent Payment Issues
7/23/25 Review New Clinical Practice Guideline on Hepatitis C
7/22/25 See Our BlueCard^® Program Checklist for Out-of-Area Member Claims
7/15/25 Review Reminder on Billing Point-of-Use Convenience Kits
7/10/25 Verify Your Directory Information Every 90 Days
7/07/25 Encourage Pediatric Well-Child Visits and Immunizations
7/02/25 Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 2
7/01/25 Update: We’re Updating Our Payment Systems to Help Improve Efficiencies
6/30/25 Prior Authorization Codes Updated for Medicare Advantage, Effective Oct. 1, 2025
6/27/25 Prior Authorization Codes Updated for Commercial Members, Effective Oct. 1, 2025
6/24/25 Clinical Payment and Coding Policy Updates
6/24/25 Watch for Our Provider Availability and Access Survey
6/23/25 Review Updates to Clinical Practice and Preventive Care Guidelines
6/20/25 ClaimsXten™ Code Update Effective Aug. 18, 2025
6/18/25 Encourage Medicare Members to Respond to Health Outcomes Survey
6/17/25 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
6/12/25 Update: No Change for NICU Levels of Care Reimbursement
6/11/25 Provider Rights and Responsibilities
6/11/25 Member Rights and Responsibilities
6/03/25 Use Simplified Referral Form for American Indian/Alaska Native Limited Cost Share Plans
6/02/25 Encourage Routine Vaccines and Well-Care Visits for Adolescents
5/30/25 Postponed: Enhanced Claim Edit for Oncology Drugs and Services for Medicare Members
5/29/25 Providers with Unused Record IDs May be Terminated from Networks
5/28/25 Prior Authorization Code Changes for Commercial Members, Effective July 1, 2025 
5/28/25 Verify Your Directory Information Every 90 Days
5/27/25 Clinical Payment and Coding Policy Updates
5/23/25 Update: Behavioral Health Substance Use Criteria for Utilization Management
5/22/25 Claims Reminders for Behavioral Health Services
5/20/25 Update: New Home Delivery Pharmacy Service to Fill Members’ Injectable GLP-1 Prescriptions
5/19/25 New Coding Policy for Global Obstetrical Maternity Services
5/13/25 Quality Measures Track Diabetes Care
5/09/25 Update: Access BlueApprovR^SM in Availity^® Authorizations, Effective in June 2025
5/06/25 Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 1
5/01/25 Records May Be Requested to Comply with Risk Adjustment Data Validation Audit
4/28/25 Clinical Payment and Coding Policy Updates
4/10/25 Watch for New Virtual Card Payments for Member Cost Share
4/09/25 Reinforce Prenatal and Postpartum Care to Support Whole Health
4/03/25 Prior Authorization Codes Updated for Commercial Members, Effective July 1, 2025
4/03/25 Prior Authorization Code Updates for Medicare Advantage, Effective July 1, 2025
4/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 2
3/27/25 Oklahoma Insurance Department and Centers for Medicare & Medicaid Services Launch Provider Directory Pilot Program
3/27/25 Clinical Payment and Coding Policy Updates
3/26/25 Groups May Update and Verify Provider Information by Roster
3/26/25 Clinical Series Program Offers Education on Pediatric Care
3/25/25 New Coding Policy for Lactation Support Services Effective June 26, 2025
3/19/25 Cigna Healthcare Medicare Advantage Transaction Complete
3/17/25 Watch for Our Annual Satisfaction Survey
3/14/25 Update Your Records with New Member ID Numbers
3/13/25 Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
3/12/25 Policy for Billing Telemedicine and Telehealth Services Updated, Effective Jan. 1, 2025
3/05/25 Earn Continuing Education Credit in Webinar on Behavioral Health in Older Adults
2/26/25 We’re Updating Our Payment Systems to Help Improve Efficiencies
2/25/25 Clinical Payment and Coding Policy Updates
2/21/25 Claims Review to Be Enhanced for Oncology Drugs and Services for Medicare Members, Effective June 1, 2025
2/14/25 Education and Residency Information Required for Directory
2/14/25 Encourage Follow-up Care after Hospital Visits for Mental Health
2/12/25 Has Your Information Changed? Update Us and the NPI Registry
2/07/25 Utilization Management Review Paused for Advanced Imaging Site of Care
2/05/25 Discuss Colon Health and Preventive Screening with Our Members
2/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 1
1/24/25 Encourage Medicare Advantage Members to Respond to Survey on Health Care Experiences
1/24/25 Update: Medical Policy Updates for Self-Administered Drugs Effective April 15, 2025
1/23/25 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
1/22/25 Hospitals Must Provide Notice to Members Under Outpatient Observation for More Than 24 Hours 
1/15/25 Medical Record Collection for Commercial Members Starts Feb. 1, 2025
1/15/25 Avoid the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
1/10/25 Quality Measures Help Track Our Members’ Heart Health
1/09/25 Laboratory Management Clinical Payment and Coding Policies Updated
1/07/25 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2025 – Part 2

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