Insights and Updates for Providers

March 2023

Updates and reminders

Tufts Health Plan SCO  |  Tufts Health Public Plans  |  Tufts Medicare Preferred

Read more for helpful updates and reminders to keep in mind this month. Topics include required data elements for coordination of benefits claims, opioid treatment performance specifications, and reminders regarding stretchers and the standard form for chemotherapy prior authorization.

Change to OncoHealth radiation program on April 1

Harvard Pilgrim Health Care Commercial  |  Harvard Pilgrim Stride (HMO) Medicare Advantage  |  Tufts Health Plan Commercial  |  Tufts Health Public Plans

As of April 1, 2023, Harvard Pilgrim’s Commercial and Stride (HMO)/(HMO-POS) Medicare Advantage plans will no longer use OncoHealth for radiation oncology medical management.

AIM Specialty Health name changing

Harvard Pilgrim Health Care Commercial  |  Harvard Pilgrim Stride (HMO) Medicare Advantage  |  Tufts Health Public Plans

Beginning March 1, 2023, AIM Specialty Health (Harvard Pilgrim and Tufts Health Public Plans’ genetic/genomic and molecular diagnostic testing services utilization management vendor) will be known by a new name: Carelon Medical Benefits Management.