Responsibilities and standards news
PriorityMedicare D-SNP Model of Care training
PriorityMedicare D-SNP Model of Care training for providers
June 30, 2025
pSA mandate, phase 1
Starting September 23, prism users will only be able to affiliate to groups or facilities that have a pSA. If the group doesn’t have a pSA, users will not be able to access the group’s data until the group assigns a pSA. This means users won’t be able to use prism to submit authorizations, see claims or appeals, etc.
June 27, 2025
2024 Child CAHPS and CSHCS CAHPS results available
The 2024 Child CAHPS and CSHCS CAHPS survey results are now available for providers.
June 27, 2025
Reminder: You must complete our MOC training by Dec. 31
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
June 27, 2025
Annual pSA renewal process
Our annual prism Security Administrator (pSA) renewal period is underway. pSAs will have until Aug. 1 to review and either approve or deny all user affiliations for your group or facility.
June 27, 2025
May 2025 medical policy updates
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in May and approved a series of medical policy updates.
June 27, 2025
Monthly record retrieval for the 2025 DBM program
Our Risk Adjustment team will start monthly email outreach to our Disease Burden Management (DBM) Program providers to collect medical records for targeted DBM members who’ve completed a visit with a provider.
June 27, 2025
You must complete our DSNP MOC training
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
June 27, 2025
We're collecting records for our Medicare retrospective chart review
Our Medicare retrospective chart review kicks off soon
June 27, 2025
Provider reenrollment for the VFC program closes on April 1
Provider reenrollment for the VFC program closes on April 1
June 27, 2025
February 2025 medical policy updates
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in February and approved a series of medical policy updates.
June 27, 2025
2025 D-SNP MOC training is now available
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
June 27, 2025