{"id":4980,"date":"2019-12-16T18:31:06","date_gmt":"2019-12-16T18:31:06","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=4980"},"modified":"2019-12-16T18:31:06","modified_gmt":"2019-12-16T18:31:06","slug":"december-2019-clinical-review-criteria","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/december-2019-clinical-review-criteria\/","title":{"rendered":"December 2019 Clinical Review Criteria"},"content":{"rendered":"<p>Health New England\u2019s Clinical Policies have been updated and can be found on the Provider Resources page at <a href=\"http:\/\/healthnewengland.org\/providers\/resources\" target=\"_blank\" rel=\"noopener\">healthnewengland.org\/providers\/resources<\/a>. On the Resources page, click on <strong><em>\u201cBehavioral Health\/Medical Policies\u201d <\/em><\/strong>to learn of the changes.<\/p>\n<p><strong><em><u><br \/>\nReviewed with Changes effective 1\/1\/20<\/u><\/em><\/strong><\/p>\n<ul>\n<li>Drug Testing (communicated change in November communication)<\/li>\n<\/ul>\n<p><strong><em><u><br \/>\nMedical Policies Reviewed with Changes effective 2\/1\/20<\/u><\/em><\/strong><\/p>\n<ul>\n<li>Artificial Intervertebral Cervical Disc<\/li>\n<li>Bronchial Thermosplasty<\/li>\n<li>Corneal Cross-Linking<\/li>\n<li>Gastric Electrical Stimulation (GES) Enterra Therapy System<\/li>\n<li>Gender Reassignment Surgery<\/li>\n<li>Home Health Care Services for MassHealth<\/li>\n<li>Outpatient Physical and Occupational Therapy<\/li>\n<li>Sacral Nerve Stimulation and Electrical Percutaneous Tibial Nerve Stimulation<\/li>\n<\/ul>\n<p><strong><em><u><br \/>\nBehavioral Health Policies Reviewed with Changes effective 2\/1\/20<\/u><\/em><\/strong><\/p>\n<ul>\n<li>Admission and Concurrent for Clinical Stablization<\/li>\n<li>Community Based Acute Treatment (CBAT) Program and Intensive Community Based Acute Treatment (ICBAT) Program<\/li>\n<li>Community Crisis<\/li>\n<li>Family Stabilization Team<\/li>\n<li>Transcranial Magnetic Stimulation (TMS)<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong><em><u>New Policies effective 11\/13\/19 <\/u><\/em><\/strong><\/p>\n<ul>\n<li>Chimeric Antigen Receptor T-Cell Therapy (CAR-T Cell Therapy) Kymriah and Yescarta<\/li>\n<li>Knee Arthroplasty and Knee Arthroscopy for MassHealth<\/li>\n<li>Lutetium LU 177 Dotatate Therapeutic (Lutathera)<\/li>\n<li>Skin and Soft Tissue Substitutes<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Health New England\u2019s Clinical Policies have been updated and can be found on the Provider Resources page at healthnewengland.org\/providers\/resources. On the Resources page, click on \u201cBehavioral Health\/Medical Policies\u201d to learn of the changes. Reviewed with Changes effective 1\/1\/20 Drug Testing (communicated change in November communication) Medical Policies Reviewed with Changes effective 2\/1\/20 Artificial Intervertebral Cervical [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3768,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[113],"class_list":["post-4980","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter","tag-clinical-policies"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2017\/12\/close_up_hand_on_laptop_keyboard-e1525890058312.jpg?fit=800%2C533","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1ik","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4980","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=4980"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4980\/revisions"}],"predecessor-version":[{"id":4981,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4980\/revisions\/4981"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/3768"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=4980"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=4980"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=4980"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}