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News & Alerts
Provider News Library
Medical and Pharmacy Benefit Duplicate Payments and Recoupment Process
Effective Oct. 1, 2021, UCare began performing duplicate payment audits of medical benefit and pharmacy benefit claims.
See the Oct. 15 Provider Bulletin for more information.
FDA Announces Chantix Recall
On Sept. 16, 2021, Pfizer announced a voluntary recall of all lots of Chantix 0.5 mg and 1 mg tablets to the patient (consumer/user) level. Patients should continue taking Chantix until they consult with their health care professional who can prescribe a replacement.
UCare’s pharmacy department will send letters to impacted members.
See the Oct. 14 Provider Bulletin for details.
Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting December 1, 2021, UCare is updating prior authorization criteria for seven drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
UCare 2022 Medicare Plans Earn 5-Star Rating from CMS
UCare is pleased to announce its 5-Star Rating from CMS for its 2022 Medicare plans.
October 2021 Health Lines
Learn about Combined Application for American Rescue Plan Rural Funding and Provider Relief Fund Phase 4 Now Open, New UCare Website Spotlight: Find a Form, UCare Connect + Medicare Service Area Expansion, Documentation Improvement: Breast Cancer, LivingWell Kid Kits, Dental Access for Members, Reminder: UCare Medicare Part D Vaccine Information, Ensure You Don’t Miss Important News, UCare Provider News Delivered to Your Team and more.
Early Intensive Developmental and Behavioral Intervention (EIDBI) Claim Payment Reminder
UCare follows Minnesota Department of Human Services guidelines for the rendering and billing of EIDBI services.
Quantity Limits (QL) Updated for Continuous Glucose Monitors on All UCare Formularies
Effective Sept. 1, 2021, quantity limits for continuous glucose monitor products will be updated.
Critical Business Reminders
UCare informs providers of critical business reminders for the Credentialing and Recredentialing Process, Pharmacy, Complex Case Management Process, Utilization Management Information, Member Rights and Responsibilities, Practitioner Support Shared Decision-Making Aids and Clinical Practice Guidelines.
Authorization and Notification Requirements Update:Outpatient Substance Use Disorder Services
Effective immediately, UCare will return to approving notifications for up to six months of services for outpatient subsstance use disorder (SUD) services for individual/group (H2035 or H2035HQ).
See the April 26 bulletin for details.
Reminder: UCare Medicare Part D Vaccine InformationStarting Jan. 1, 2021, UCare began denying claims for providers administering Part D vaccines in their clinics. Provider will need to bill both the vaccine and administration through the member’s Part D benefit.
See the Feb. 4 bulletin for details.
Changes to the Payment and Remittance Selection ProcessEffective immediately, UCare is changing the process to request updates to the provider’s payment and remittance selections.
Read the Dec. 18 bulletin for additional details on the changes.
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