Insights and Updates for Providers - September 2025

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Reminder: Expansion of vendor program and training sessions

Beginning Oct. 1, 2025, Evolent will be conducting utilization management for spine and interventional pain management services for Tufts Medicare Preferred members.

Change to HEDISĀ® specification for breast cancer screening

HEDIS has expanded their recommended age range for breast cancer screenings to ages 40 through 74.

ChoiceNet: no tiering changes for 2026

All provider tier classifications for Harvard Pilgrim’s ChoiceNet HMO and PPO plans will remain the same for the 2026 plan year.

Point32Health offers continued coverage of COVID-19 vaccine

Learn more about our continued coverage of the COVID vaccine for members age six months and older.