Provider Quick Alert

May 1, 2020
Review all  Medical Coverage Policies at
New and Amended Medical Policies

P = Payment Change
C = Code Change
V = Verbiage Change

Medical Policy Number
Medical Policy Name Effective Date of Change Description of Changes
BI419   V
SGLT-2 Inhibitors 04/01/20 Retired policy.
BI420   V
DPP4 Inhibitors
Retired policy.
BI156  V
Removed pre-authorization requirement for guanfacine ER.
For questions about QualChoice Medical Coverage Policies, please contact your Provider Relations Representative 
at 800.235.7111 or 501.228.7111, ext. 7004, Monday through Friday, 8:00 a.m. to 5:00 p.m.

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