New tip sheet available for the Behavioral Health HEDIS measure: Follow-Up Care for Children Prescribed ADHD Medication (ADD)
Nov. 2022Important Notices
The ADD HEDIS® measure outlines the importance for members 6 to 12 years old who are newly prescribed a medication for ADHD to receive, at minimum, three appointments—an initial appointment with the prescriber and subsequent appointments with the treatment team, including behavioral health treatment providers—within 10 months of starting the new medication. The tip sheet defines the HEDIS measure and offers providers tips to ensure continuity of care for their patients who are prescribed medications for ADHD for the first time. Learn more about the ADD HEDIS measure.
HEDIS®
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.
HEDIS®
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.
Recent Announcements
The importance of PRD forms for complex patients and staying updated on changes
Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.Aug. 2025Important Notices
Important announcement: UPMC Health Plan retires MP.PA.147
This communication is in regards to UPMC Health Plan Policy MP.PA.147 – Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older. UPMC Health Plan previously communicated that the prior authorization requirement under this policy would be paused until Sept. 1, 2025. However, policy MP.PA.147 has been retired, and this policy will no longer be implemented or active.Aug. 2025Important Notices
CMS expands Medicare Advantage RADV audits to all eligible plans
On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.Aug. 2025What's New