Payer Updates | September 2025

For a curated summary of the latest payer updates* impacting Northern Michigan provider offices, grouped by payer then category, please see below:

BCBSM and BCN

All Providers: To fulfill regulatory guidelines and National Quality Program Guidelines, BCBSM Conducting Survey on Appointment Wait Times. SOURCE

All Providers: Continued longer claims processing times due to transition to NASCO. SOURCE

All Providers: New prior authorization website coming soon. SOURCE

GI and Rheumatology: Effective Sept. 1, BCBSM has replaced Humira with biosimilars for Medicare Advantage members. SOURCE

*News items from the following payers were reviewed for this month’s highlighted articles: Aetna, BCBSM, Blue Care Complete, Blue Care Network (BCN), Health Alliance, McLaren, Molina, and Priority Health.