Announcements and News

In this ever changing world of health care, you as a provider need to stay on top of the latest news in our industry. Aetna Better Health of Virginia helps you with this and takes the lead. We provide you with news and updates from us, as well as the latest breaking stories from the health care industry as a whole. We know that you want to stay informed, and here at Aetna Better Health of Virginia, we give you the tools to do so.

Provider Newsletter

Provider Newsletter - Winter 2016-17

Provider Newsletter - Fall 2016


Other Important Announcements

Peer Services Cover Memo

Provider Notice 06/16/2017 - There has been an amendment to the provider manual by the Department of Medical Assistance Services (DMAS). This amendment includes information for providers regarding Medicaid/FAMIS individuals who are enrolled in a managed care program. Click here to read the amendment.

Provider Notice 05/08/2017 - Attention Aetna Better Health of Virginia providers. Aetna’s operations in the individual and exchange market do not impact Medicaid/FAMIS. These are two different products. We are not leaving. We want to make sure you and our provider community know, we aren't going anywhere.

Provider Notice 03/28/2017 - Provider training opportunity for new ARTS program. Learn more, including how to register.

Effective 02/01/2017 - CVS Caremark Specialty will serve as our exclusive specialty provider for specialty medications. Please view our notice for more information. 

Provider Notice 01/20/2017 - This is a reminder for providers attesting to meet ASAM levels 2.1 to 4.0. The deadline to submit is January 25. Learn more.

Provider Notice 12/14/2016 - You recently received a fax blast regarding prior authorizations for Circumcision services. Upon further review, we realized we were in error regarding CPT code 54150 (Circumcision for Newborns with clamp device) and have made the appropriate updates to the information in the letter that was sent via fax blast last month.

Effective 01/01/2017, Aetna Better Health of Virginia will require prior authorization for Circumcision services 54150, 54162, 54360 and 55180. The  document has more information.

Provider Notice 12/09/2016 - This is a reminder for providers attesting to meet the ASAM levels 2.1 to 4.0. Please remember that the deadline for attestation is December 15, 2016. This form needs to be submitted to DMAS. Providers will need to demonstrate they meet ASAM criteria in order to be credentialed by the Medicaid MCOs and Magellan to participate in the DMAS Addiction and Recovery Treatment Services (ARTS) program which will be implemented April 1, 2017. The document has more information.

Effective 11/01/2016, eviCore is implementing a change of process for initiating Musculoskeletal pre-certification requests. The document has more information

Effective 10/25/2016, Aetna Better Health of Virginia members will require prior authorization for Cardiology services from eviCore healthcare for dates of service 11/01/2016 and after. The document has more information.

Effective July, 2016, Aetna Better Health of Virginia will be implementing MCG (Milliman Care Guidelines) Behavioral Health Guidelines (MCG BHG) as the primary medical necessity criteria for behavioral health. The document has more information.

On April 1, 2016, Aetna Better Health of Virginia entered into a partnership with eviCore healthcare to manage utilization of High-Tech Imaging, OB, and Non-OB Ultrasound studies. The document has more information.