Member Services: 1-844-243-5187 (TTY use 711) Available 8am - 7pm Monday - Friday | Language Assistance

Medical Policy & Procedure Updates

 
  • Miami Children’s Health Plan has agreed to cover Hepatitis A vaccines for Medicaid enrollees over the age of 20 when administered at a County Health Department (CHD). View details of this update here.
 
  • A new policy on Onasemnogene Abeparvovec-axgt (Zolgensma ®) will be implemented on May 1, 2020 for Miami Children's Health Plan. Procedure codes J3490, J3590, 96365-96368 will require prior authorization, and final CMO and FL Pharmacy Director approval prior to coverage of Zolgensma treatment for Spinal Muscular Atrophy. For more information, please reference the policy here.
 
  • A new policy on Cochlear Implants will be implemented on May 1, 2020 for Miami Health Plan. Procedure codes 69930, 92700, L7510, L8614, L8615, L8616, L8617, L8618, L8619, L8623, L8624, L8627, L8628, L8629 will require prior authorization as outlined by the policy guidelines. For more information, please reference the policy located here.
 
  • A new policy on Pain Management will be implemented on May 1, 2020. Procedure codes 64479, 64480, 64483, 64484, 20526, 27096, 28899, 64450, 64455, 64461, 64462, 64463, 64490, 64491, 64492, 64493, 64494, 64495, 77003 for Nerve Block, Paravertebral, Facet Joint, and SI injections, Epidural Injections. and Peripheral Nerve Blocks will require prior authorization as outlined by the policy guidelines. For more information, please reference the policy located here.
Facebook Link        

 

Miami Children's Health Plan is a Managed Care Plan with a Florida Medicaid Contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the Managed Care Plan. Limitations, copayments, and/or restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change.

All Rights Reserved ©2020 Miami Children’s Health Plan