Neighborhood News
Each article below is hyperlinked to a PDF/printable version of the publication. If you would like to receive our newsletter, please click here to register your email and Neighborhood News will be delivered straight to your inbox. Once you’re signed up, you’ll receive critical news and information on topics such as new initiatives, policy changes, and much more.
Action Required
- 2027 Annual Provider Training Now Available
- Do Not Bill INTEGRITY for Duals Members for Medicare Cost Share
Announcements
- Commercial Member ID Card Update for 2027
- Help Your Patients Get Covered in 2027
- How You Can Help Your Patients Stay Covered with Changes to Medicaid
- Important Medical and Behavioral Health Claim Updates
- Medicare-Medicaid Plan (MMP) Claims Submission Deadline
- Neighborhood Health Plan of Rhode Island Receives NCQA Recognition
- New PDF Search Feature Now Available on the Provider Website
- New Transplant Prior Authorization Request Form and Guidelines Now Available
- Updated Prior Authorization Page Now Available
Behavioral Health
LTSS
- Assisted Living Tier Change Process
- Coding Change for Home Health Aide Services – Commercial
- LTSS Claims and Billing Resources Now Available on NaviNet
- New LTSS Benefits Grid Available
Payment Policies
Pharmacy
- Commercial Pharmacy Benefit Updates
- How to Bill 340B Appropriately
- Medicaid and Commercial Limited Specialty Pharmacy Network Coverage Update
- Medicaid Pharmacy Benefit Updates
- Pharmacy Prior Authorization Forms
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
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.
Quality Improvement
- 2026 Neighborhood Membership Language Profile
- Appropriate Antibiotic Use
- Eye Exams for Patients with Diabetes – Coding Best Practices
- National Lead Poisoning Prevention Week You Can Help!
- Statin Therapy for Patients with Diabetes
- Well Child Visits 2026
Risk Adjustment
Utilization Management
- Authorization Requirement Update – Interventional Cardiology (Medicaid)
- Important Authorization Steps for High End Radiology and Interventional Cardiology Providers
- Specialty Medication Prior Authorization Criteria
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.