04/14/2026
Health Alliance Plan
Health Alliance Plan Managed Care Committee Member
April Danish, CHONC - Newland Medical Associates
Reimbursement for G2211
Effective with dates of services on or after July 1, 2026, HCPCS code G2211 is only payable for HAP Medicare Advantage members when the service meets the billing guidelines and is supported in patient medical records. READ MORE
Clinical Trials Billing Requirements Coming Soon
Effective May 1, we will implement the billing guidelines below for items and services furnished to members enrolled in approved clinical trials. For HAP Commercial plans, routine patient care costs are covered as required under the Affordable Care Act (ACA). For HAP Medicare Advantage (MA) plans, coverage of routine costs follows Medicare rules. In qualifying clinical trials, Original Medicare (FFS) processes trial-related services, and the MA plan coordinates secondary cost-sharing. READ MORE
March 2026 Updates from HAP CareSource
Review recent updates relevant to HAP CareSource’s Michigan participating providers HERE
Monthly Reminders
For a listing of several resources to make it easier to do business with HAP CLICK HERE
Reminder: Ordering Genetic Tests for HAP Members
Henry Ford Center for Precision Diagnostics (HFCPD) at Henry Ford Hospital is HAP’s preferred provider for genetic and cytogenetic testing. This arrangement requires most genetic and cytogenetic testing (CPT ranges 81105-81364, 81400-81479 and 88230-88299) to be performed at HFCPD. Per HAP member benefit policies, tests within these CPT ranges which are performed elsewhere may or may not be reimbursed. READ MORE
Gene Therapy Prior Authorization
All gene therapy requires prior authorization for all HAP Commercial and Medicare Advantage members. Reminder! You can find prior authorization requirements online. Just log in at hap.org, select Quick Links, Procedure Reference Lists; and Services that require Prior Authorization list.
CMS Required Forms for Hospital Inpatients
Per the Centers for Medicare and Medicaid Services (CMS), hospitals are required to provide the Important Message from Medicare (IM) form to all Medicare beneficiaries who are hospital inpatients. The IM informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights. READ MORE