Below is a listing of the policy activity that we have posted to our website from May 26 ? June 24, 2014.

New policies

The following policies have been newly developed to communicate coverage and/or reimbursement positions, reporting requirements, and other processes and procedures for doing business with AmeriHealth. Policy # Title Notification date Effective date 00.10.40 Reimbursement for Certified Registered Nurse Practitioners (CRNP) N/A January, 1 2014 (policy published on June 4, 2014) 08.01.17 Elosulfase alfa (Vimizim^TM) June 18, 2014 July 18, 2014

Updated policies

The following policies have been reviewed and updated to communicate current coverage and/or reimbursement positions, reporting requirements, and other processes and procedures for doing business with AmeriHealth. Policy # Title Type of policy change Notification date Effective date 00.06.02k Preventive Care Services Medical Necessity Criteria; Medical Coding June 5, 2014 September 3, 2014 02.01.01c Home Health Care Services Medical Necessity Criteria; Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update April 23, 2014 (revised June 19, 2014) July 22, 2014 05.00.14g High-Frequency Chest Wall Oscillation Devices Medical Necessity Criteria June 18, 2014 July 18, 2014 05.00.26c Prothrombin Time Monitor for Home Anticoagulation Management Medical Necessity Criteria; Medical Coding; Guidelines May 5, 2014 June 4, 2014 05.00.30i Noninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices and Bi-Level Devices Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update May 5, 2014 June 4, 2014 07.03.03f Medical Evaluation and Management for Attention- Deficit Hyperactivity Disorder (ADHD) General Description, Guidelines, or Informational Update; Coverage and/or Reimbursement Position N/A June 18, 2014 07.03.15c Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS) General Description, Guidelines, or Informational Update N/A June 18, 2014 07.07.01h Routine Foot Care For Certain Medical Conditions Informational Update N/A June 18, 2014 07.11.01b Smell and Taste Dysfunction Testing Medical Coding N/A June 4, 2014 08.00.33j Trastuzumab (Herceptin^®) Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update April 23, 2014 July 22, 2014 08.00.34g Infliximab (Remicade^®) Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update May 22, 2014 June 23, 2014 08.00.50l Rituximab (Rituxan^®) Medical Coding March 5, 2014 June 3, 2014 08.00.58c Risperidone (Risperdal^® Consta^®) Injection Medical Coding; General Description, Guidelines, or Informational Update N/A June 18, 2014 08.00.62e Abatacept (Orencia^®) for Injection for Intravenous Use Coverage Position; Medical Necessity Criteria; General Description March 5, 2014 June 3, 2014 08.00.85d Tocilizumab (Actemra^®) for Intravenous Infusion Medical Necessity Criteria; General Description March 5, 2014 June 3, 2014 08.00.98b Eribulin Mesylate (Halaven^TM) Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update N/A June 18, 2014 11.00.06e Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring for Adults Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update April 23, 2014 July 23, 2014 11.02.10j Endovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms General Description; Coverage Position; Medical Necessity Criteria; Medical Coding March 26, 2014 June 24, 2014 12.01.01x Experimental/ Investigational Services Medical Coding; Coverage Position April 10, 2014 July 9, 2014

Reissued policies

The following policies have been reviewed, and no substantive changes were made. Policy # Title Reissue effective date 08.00.49c Dofetilide (Tikosyn^®) Use In the Inpatient Setting May 28, 2014 (published May 28, 2014) 11.02.02e Treatment of Medical and Surgical Complications May 28, 2014 (published May 29, 2014) 11.08.17d Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Nails June 11, 2014 (published June 12, 2014) To view policy activity, go to our Medical Policy Portal and select Accept and Go to Medical Policy Online. You can also view policy activity using the NaviNet^® web portal by selecting Reference Tools from the Plan Transactions menu, then Medical Policy. Be sure to check back often, as the site is updated frequently.

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