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.
Upcoming changes as we partner with Medica to align best practices and share technology.
Issued: January 2023
Audience: All in-network providers
What to expect in 2023
2023 member plan and benefit highlights for provider awareness.
Issued: November 2022
Audience: All in-network providers
Effective date: 1/1/23
We are transitioning the claim appeals application in the Provider Portal.
Issued: August 2022
Audience: All in-network providers
Effective date: Changed to 8/24/22
View the new claim appeals portal application
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: 1/1/22
Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/22
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: 12/1/21
Issued: August 2021
Audience: All providers
Effective date: N/A
Issued: August 2021
Audience: In-network prescribers
Effective date: 10/1/2021 & 1/1/22
Issued: July 2021
Audience: All in-network providers
Issued: July 2021
Audience: All in-network providers
Effective date: 7/1/21
Issued: May 2021
Audience: All in-network providers
Effective date: 7/1/21
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: 7/1/21
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: 7/1/21
Announcement of provider network change detailing continuity of care and transitional information.
Issued: February 2021
Audience: Providers in Dodge and adjacent counties
Effective date: 3/1/21
Audience: All in-network providers
Notice dated: Dec. 30, 2022: Features new medical policies for oncology genetic testing and transplantation.
Notice dated: Dec. 1, 2022: Features rare diseases and system specialty specific new genetic testing medical policies.
Notice dated Nov. 1, 2022: Features prenatal new genetic testing medical policies, updated clinical guidelines for imaging and MSK, oncology program reminders and ACA medical record reviews.
Notice dated: June 1, 2022
Notice dated: April 1, 2022
Notice dated: April 29, 2022
For pharmacy updates issued on and after April 1, 2022, see the medical and drug policy updates listed on this page.
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: 6/1/22
Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies
Issued: February 2022
Effective date: 5/1/22
INFUGEM-gemcitabine, Parenteral Iron products and retired policy
Issued: December 2021
Effective date: 4/1/22
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: 3/1/22
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: 2/1/22 & 4/1/22
Medically Administered Oncology Products, Pegfilgrastim Products, PROLIA, XGEVA and Retired Policies
Issued: October 2021
Audience: All in-network providers
Effective date: 1/1/22
ADAKVEO (crizanlizumab) and SIMPONI ARIA (golimumab)
Issued: July 2021
Effective date: 11/1/21
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: 10/1/21
Medically administered oncology products, SPRAVATO (eskatamine) and retired drug policies.
Issued: June 2021
Effective date: 9/1/21
OCREVUS (ocrelizumab)
Issued: April 2021
Effective date: 8/1/21
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: 7/1/21
PROLIA/XGEVA, LUPRON-ELIGARD & INFLIXIMAB infusions
Issued: March 2021
Effective date: 6/1/21
Immune globulin
Issued: January 2021
Effective date: 5/1/21