Effective January 1, 2016, changes to certain guidelines will apply to your Tufts Health Together and Tufts Health Direct patients.
Effective October 1, 2015, Tufts Health Public Plans will cover applied behavioral analysis (ABA) services to Tufts Health Together members under 21 years of age. Children with autism under 21 years of age will be eligible to receive this service with prior authorization.
Tufts Health Public Plans members will have access to
prenatal services through a new program with the Pettaway Pursuit Foundation
On claims processed
with a date of service on or after January 1, 2016, we will be instituting
additional payment coding edits for various drugs and biological agents.
Beginning with claims
processed on or after January 1, 2016, Tufts Health Public Plans will implement
modifications to our durable medical equipment (DME), orthotic, prosthetic, and
supply coding edits to reflect nationally and regionally accepted standards.
National Committee for Quality Assurance’s (NCQA) Health Insurance Plan Ratings 2015 – 2016 have been released.
We are pleased and proud to share that as of October 2015, we will become known by one name: Tufts Health Plan. This change of name, from Tufts Health Plan – Network Health to Tufts Health Plan, reflects our ongoing assimilation into the Tufts Health Plan family.
On September 3, 2015, the U.S. Department of
Health and Human Services Office of Civil Rights released a proposed rule on nondiscrimination under Section 1557 of the Affordable Care Act (ACA). Section
1557 is the civil rights provision of the ACA. Section 1557 is the civil rights provision of the ACA.
Effective December 1, 2015, Tufts Health Public Plans will implement changes to our prior authorization program for the management of spinal conditions, including spine surgery and interventional pain management procedures.