Provider communications

We release communications to in-network providers about changes to health plan procedures, policies and benefits, as well as information about larger initiatives. This page lists some of our issued notifications for reference.

Billing & reimbursement change for certain skilled nursing facility claims

Per Wisconsin Medicaid policy, providers must use HIPPS code with a corresponding revenue code on applicable SNF claims submitted to Dean Health Plan. 
Issued: May 2022
Audience: SNF providers serving DeanCare Gold or Dean Select members.
Effective date: 1/1/2022

Plan and benefit changes for 2022

Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/2022


New drugs are not covered until reviewed and approved by P&T committee

FDA approved drugs that are new to the market will not be covered until they are reviewed and approved by P&T Committee.
Issued: September 2021
Audience: All in-network providers
Effective date: 12/1/2021


New partnership with Medica 

Issued: August 2021
Audience: All providers
Effective date: N/A


New policy for viscosupplement products 

Issued: August 2021
Audience: In-network prescribers
Effective date: 10/1/2021 & 1/1/2022


Preventive care and screenings 

Issued: July 2021
Audience: All in-network providers  


Brand Adderall XR removed from formulary 

Issued: July 2021
Audience: All in-network providers ­
Effective date: 7/1/2021


New member ID cards for some members

Issued: May 2021 ­
Audience: All in-network providers ­
Effective date: 7/1/2021


Medicaid product expansion

Dean Health Plan BadgerCare Plus available to residents in Fond Du Lac and Green counties.
Issued: May 2021 ­
Audience: Fond Du Lac and Green providers ­
Effective date: 7/1/2021


Total knee & total hip arthroplasty prior authorization changes

Changes to the prior authorization process for inpatient and outpatient total knee arthroplasty and total hip arthroplasty procedures.
Issued: April 2021 
Audience: Orthopedists and orthopedic surgeons        
Effective date: 7/1/2021


Marshfield Medical Center-Beaver Dam and Marshfield Clinic sites no longer in-network

Announcement of provider network change detailing continuity of care and transitional information.
Issued: February 2021        
Audience: Providers in Dodge and adjacent counties
Effective date: 3/1/2021


Member cost-share waiver

Cost share waiver for office visits through Dec. 31, 2020.
Issued: October 2020        
Audience: All in-network providers                 
Effective date: 10/15/2020


Plan and benefit changes for 2021

Annual notification with member-centered plan and benefit topics for provider awareness for 2021.
Issued: October 2020        
Audience: All in-network providers                 
Effective date: 1/1/2021


Provider portal bulk edit function

Portal function allowing provider portal site administrators to apply updates to multiple user accounts all at once.
Issued: June 2020            
Audience: Portal site administrators                
Effective date: 6/29/2020


New provider portal

Per Wisconsin Medicaid policy, providers must use HIPPS code with a corresponding revenue code on applicable SNF claims submitted to Dean Health Plan. 
Issued: March 2020            
Audience: All in-network providers                
Effective date: 3/8/2020

 



Medical and drug policy updates

Audience: All in-network providers

Notice dated: June 1, 2022

Notice dated: April 1, 2022

Notice dated: April 29, 2022 



Pharmacy material change notices

Audience: All in-network providers


ALDURAZYME-laronidase, ARANESP-darbepoetin alpha, ELAPRASE-idursulfase, ELELYSO-taliglucerase alfa, Epoetin Alfa Products, NAGLAZYME-galsulfase, VIMIZIM-elosulfase, and retired policy
Issued: February 2022
Effective date: 6/1/2022 

Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies
Issued: February 2022
Effective date: 5/1/2022 

INFUGEM-gemcitabine, Parenteral Iron products and retired policy
Issued: December 2021
Effective date: 4/1/2022

CRYSVITA (burosumab)
Also includes changes to fax and phone numbers on Medical Benefit Drug Prior Authorization Forms and the new Pharmacy and Therapeutics Committee review process.
Issued: December 2021
Effective date: 3/1/2022 

Medicare Part B Step Therapy, ORENCIA (abatacept-IV) SIMPONI ARIA (golimumab), FLOLAN-epoprostenol-REMODULIN-treprostinil and New Drug Policies for Medicare Advantage
Issued: October 2021
Audience: All in-network providers
Effective date: 2/1/2022 & 4/1/2022 

Medically Administered Oncology Products, Pegfilgrastim Products, PROLIA, XGEVA and Retired Policies
Issued: October 2021
Audience: All in-network providers
Effective date: 1/1/2022 

ADAKVEO (crizanlizumab) and SIMPONI ARIA (golimumab)
Issued: July 2021
Effective date: 11/1/2021 

ALPHA 1- ANTITRYPSIN INHIBITOR, KRYSTEXXA (pegloticase), VISUDYNE (verteporfin), Antihemophilic Factor VIII Products, Antihemophilic Factor IX Products, Hyaluronic acid derivatives, Duchenne NMN, ENTYVIO (vedolizumab) and Antihemophilia Factors and Clotting Factors
Issued: July 2021
Effective date: 10/1/2021

Medically administered oncology products, SPRAVATO (eskatamine) and retired drug policies.
Issued: June 2021
Effective date: 9/1/2021 

OCREVUS (ocrelizuab)
Issued: April 2021
Effective date: 8/1/2021 

BELEODAQ, BLINCYTO, ERBITUX, CEREZYME®, ELAPRASE®, EVRYSDI, LUMIZYME®, NAGLAZYME®, VIMIZIM®, & VPRIV®.
Also includes changes to preventive drug list for commercial members
Issued: April 2021
Effective date: 7/1/2021 

PROLIA/XGEVA, LUPRON-ELIGARD & INFLIXIMAB infusions
Issued: March 2021
Effective date: 6/1/2021 

Immune globulin
Issued: January 2021
Effective date: 5/1/2021 

Trastuzumab products
Issued: December 2020
Effective date: 4/1/2021 

Pegfilgrastim, Pertuzumaband and Trastuzumab products
Issued: October 2020
Effective date: 2/1/2021 

REBLOZYL, ENHERTU, KADCYLA and TRODELVY
Issued: September 2020
Effective date: 1/1/2021 

SOLIRIS and ULTOMIRIS
Issued: May 2020
Effective date: 8/1/2020