View the latest updates to Medical Clinical Policies
2026
- Important Prior Authorization Updates: Effective October 1, 2026
- Availity Essentials: New RFAI Feature
- New to Availity Essentials or looking to sharpen your skills?
- Evolent Prior Authorization Updates Effective January 1, 2027 (PDF)
- Annual Model of Care Training Required
- Updates to Inpatient and Post-Acute Care Pre-and Post-Decision Peer-to-Peer Discussions
- CMS Launches Medicare GLP-1 Bridge Program
- Updated Medicare Outpatient Observation Notice Now in Effect
- Reminder: Access Toll-Free Fax Numbers at wellcare.com
- Updated Clinical and Payment policies: Effective April 1, 2026
- 6 Degrees Health – Wellcare Clean Claim Vendor Effective March 30, 2026
- Annual Wellness Visit and Routine Physical Exam Coding Refresher
- CareCentrix Medical Necessity Review Criteria Change: Effective May 1, 2026
- Cotiviti Evaluation and Management Leveling
- Review CPT Codes for Medicaid, Medicare, and Marketplace Plans That Will No Longer Require Prior Authorization
2025
- Medicare Telehealth Flexibilities for Wellcare Members through 2026
- Important Prior Authorization Updates: Effective April 1, 2026 (PDF)
- CMS Prior Authorization Change: Effective January 1, 2026
- Meridian’s Clean Claim Vendor is 6 Degrees Health
- Important Prior Authorization Updates: Effective October 17, 2025
- Medicare Prior Authorization Change Summary: Effective 10/1/2025
- Introducing Availity Editing Services
- Model of Care Training Required
- Medicare Prior Authorization Change Summary: Effective 7/1/2025
- Notice of Changes by Medicare That May Affect Drug Coverage
