The Centers for Medicare & Medicaid Services issued the transcript on August 15, 2012 of the Open Door Forum call from August 7, 2012 on the manual medical review process scheduled for implementation on October 1, 2012. To access the transcript, click…

Highmark Inc., who serves 4.9 million members in Delaware, Pennsylvania, and West Virginia, announced on June 19, 2012 they will begin requiring prior authorization for physical therapy, occupational therapy, and manipulation services beginning September 1, 2012. In the press release, Highmark stated this program applies to Highmark members in insured groups in Pennsylvania and West Virginia. It also applies to Highmark individual members and Medicare Advantage members in those states. Groups that are self-insured may also participate. Members will not need to take any special steps as a result of this program. Providers will work directly with the vendor (Healthways)