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HealthPro News – October 2026 [PDF]
HealthPro News
A monthly publication for participating HMSA health care providers, facilities, and their staff.
October 2026
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Stefanie Park, M.D., HMSA vice president and chief medical officer We appreciate the care that you provide to our members. This monthly HealthPro News and our Provider Resource Center are intended to provide you with the information you need to do business with us. We’re upgrading our site and hope that the changes will improve accessibility, searchability, and timeliness. - Stef |
| ADMINISTRATION & NEWS | |
|---|---|
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Help Us Measure Access to Specialty Care [PDF] Telephone survey of specialist offices from mid-October through November. |
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Submit your attestation each quarter confirming your practice and location information. |
| CONTRACT NOTIFICATION | |
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Effective as of Sept. 1. |
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Significant Changes for Policies Requiring 60-day Notice [PDF] Effective Dec. 1. |
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Effective Dec. 1. |
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Changes to ASAM 3.5 Residential Treatment Authorizations [PDF] Effective Jan. 1, 2027. |
| CODING & CLAIMS | |
|---|---|
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Transitional Care Management Coverage Changing [PDF] TCM codes will no longer be covered for commercial and QUEST members. |
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Hospital Outpatient Billing Update: Blood Transfusion Services [PDF] Requirements effective Dec. 1. |
| PLANS | |
|---|---|
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Medicare Advantage Plan Updates for 2027 [PDF] Changes needed as HMSA navigates significant federal and market pressures. |
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ACA Individual Network Change [PDF] Plans will transition to a Hawaii-only provider network. |
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New Dual Care Member Card [PDF] The updated card is intended to make it easier for providers. |
| PROGRAMS | |
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Required Documentation for Medical Respite Referrals [PDF] Ensure all required documentation is completed before admission. |
| POLICY NEWS | |
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Annual Review of Medical Policies [PDF] Effective as of Aug. 28. |
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Codes That Do Not Meet Payment Determination Criteria [PDF] Complete list in the PRC. |
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Claim Documentation Requirements [PDF] Codes have been added to the list. |
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Precertification Requirements [PDF] List found online. |
| CALENDAR | |
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Health Education Workshops [PDF] No-cost sessions that can help your patients. |
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Health- and fitness-related activities. Nominal fees. |
· COMMERCIAL · QUEST · MEDICARE
Bulletin of Annual Notices
From HMSA’s Quality Management Department
2026
Click the links below to learn more.
View past issues of HMSA’s HealthPro News in the Provider Resource Center.
Revision History
| Date | Nature of Revision |
|---|---|
| 10/01/2026 | Updated content with October 2026 Health Pro News information. |
| 09/28/2026 | Migrated to new platform. |