Neighborhood News
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Action Required
Announcements
- 2024 Provider Manual Available
- Change in Custodial-Level Authorizations for Non-LTSS Members
- Discontinuation of the LTSS Alternative Payment Model
- Home Care Discharge Communication E-Form Now Available
- LunaYou Pilot Program Ending
- Meal Delivery Benefit for New Medicaid Moms
- Medicaid Redeterminations for Households with Kids Underway: Help Patients Keep Their Coverage
- Policy Update for Home Health Agencies
- Reinstatement of PCP Requirement for Select Services
- Request for Claim Review, New Terminology
- Update to Neighborhood’s Telemedicine/Telephone Services Policy
- Updated Electronic Payment and Remittance Application Now Online
Claims
Payment Policies
Pharmacy
- Cost Saver Program for Commercial Members
- Electronic Prior Authorization for the Pharmacy Benefit
- How to Bill 340B Appropriately
- Medicaid and Commercial Limited Specialty Pharmacy Network
- Medical Benefit Prior Authorization Submission
- Opioid Prescribing and Alternative Therapies for Neighborhood INTEGRITY Members
- Pharmacy Benefit Medicaid Drug Rebate Program (MDRP)
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
- Reminder: Specialty Medication Prior Authorization Criteria
- Respiratory Syncytial Virus (RSV) Prevention Update
- Upcoming Medicaid Pharmacy Benefit Preferred Therapy Changes
- Upcoming Pharmacy Benefit Changes for Inhaler and Insulin Products
Monthly Pharmacy Benefit Changes: On a monthly basis, Neighborhood places a list of formulary changes on its website for each line of business. For more information, please visit the Pharmacy Provider Resources webpage.
Risk Adjustment
Quality Improvement
- Criteria for Gender Reassignment Surgery
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Reminders
- Appropriate Use of Expedited Prior Authorization Requests
- Compliance Reminder for Nursing Facilities
- STI Resources from RI Department of Health
The News and Updates section of the Neighborhood website is used to share important news and information including notifications on payment policies, operational issues, and more.