Provider Update

This quarterly newsletter reports on business and clinical news, including a summary of clinical updates, continuing education opportunities, and drug formulary updates. Newsletters are available online for one year.


September 2022 (PDF)

Highlights include:

  • Advanced Care at Home program starts in October
  • Take our Practitioner Satisfaction Survey
  • Olympia Medical Center is tops
  • Sexually Transmitted Infection Guideline updated
  • Clinical and pharmacy news
  • Continuing medical education events

June 2022 (PDF)

Highlights include:

  • New Advanced Care at Home program
  • Enhancements to Eligibility & Benefits Inquiry tool
  • Recent letters to providers
  • Updates to opioid na├»ve definitions
  • Continuing medical education events

March 2022 (PDF)

Highlights include:

  • Authorization no longer required for mental health outpatient therapy/psychiatry
  • Reimbursement for rapid antigen home tests
  • HR 133 legislation update
  • 2022 drug formularies

December 2021 (PDF)

Highlights include:

  • The No Surprises Act: Updates and information
  • Medicare news
  • New member ID cards on the way
  • Optical and hearing hardware changes
  • Kaiser Permanente to partner with National Transplant Services

September 2021 (PDF)

Highlights include:

  • Kaiser Permanente making COVID-19 vaccines mandatory for all its employees and physicians
  • Should I use chart access message or referral message in Affiliate Link?
  • Medicare coordination of benefits
  • Affiliate Link enhancement: Referral notifications now viewable as a printable PDF
  • Changes to home infusion and ambulatory infusion suite place of service coding for prior authorizations and billing
  • Requesting physical therapy services for Access PPO members
  • Recent letters to providers
  • New prior authorization criteria for Descovy when used for PrEP
  • New acute benzodiazepine quantity limits beginning October 1, 2021 for commercial members
  • Kaiser Permanent 2021 drug formularies

June 2021 (PDF)

Highlights include:

  • New Affiliate Link re-authorization process now available for providers
  • Change to how Affiliate Link users access referral notifications
  • Streamlining Mental Health & Wellness authorization and reauthorization requests
  • Always verify patient coverage prior to visit
  • Communication is key in tragic emergency department situations
  • Infusion site of care criteria
  • Recent letters to providers
  • Diagnosis Related Group post-pay reviews begin
  • Primary hrHPV is now default test for Cervical Cancer Screening
  • Asthma Diagnosis and Treatment Guideline update
  • Updated recommendations for gonorrhea treatment in patients and their partners
  • Kaiser Permanent 2021 drug formularies

March 2021 (PDF)

Highlights include:

  • Focus on member satisfaction: What is the Medicare CAHPS survey?
  • First call guide for ambulance partnerships for Kaiser Permanente
  • HEDIS® medical record review season: February-May 2021
  • CMS and Department of Health COVID-19 vaccination information added to provider site
  • Vaccination help for Washington state schools employees
  • Streamlining Mental Health & Wellness authorization and reauthorization requests
  • Threshold decrease for claims pre-payment and medical necessity review for inpatient and outpatient claims
  • Routine hepatitis C screning now recommended for all adults - not just baby boomers
  • New guideline provides treatment options for patients with opioid use disorder
  • Kaiser Permanente 2021 drug formularies

December 2020 (PDF)

Highlights include:

  • Introducing new networks, plans, and initiatives for 2021
  • New VerifyHCP® clinician directory verification panel
  • Changes to our Women's Health payment policy
  • COVID-19 Household Prevention program resources available to our members
  • Recent letters to providers
  • New and updated payment policies
  • Tips on how to navigate the prescription drugs prior authorization process
  • Acupuncture Medicare benefit for chronic low back pain
  • Updated ASCVD prevention guidelines
  • 2021 summary of opioid prescribing edits
  • Kaiser Permanente 2021 drug formularies