• Updated Medical Policies

  • The Affinity Health Plan Medical Policy and Benefits Committee added a new policy and revised the current ones for providers and members, effective June 2020. Providers should review all policies. These policies supplement the MCG and eviCore guidelines, as well as  the Medicare and Medicaid policies and rules, all of which help Affinity Health Plan determine the medical necessity of a requested treatment.

    The policies are:

    • Admission Review with Minimal Information
    • Allergy Immunotherapy
    • Cosmetic Services
    • COVID-19 Testing (NEW) – This policy reviews the circumstances under which different COVID-19 tests are medically necessary.
    • Cryotherapy
    • Gender Dysphoria
    • Interspinous and Interlaminar Stabilization/Distraction Implants
    • Manipulation Under Anesthesia
    • Pediatric Multidisciplinary Feeding Therapy

    The policies can be found at http://www.affinityplan.org/Providers/Support/Medical-Policies/Medical-Policies.

    Providers are encouraged to bookmark this page and revisit often for updates.