IMPORTANT MEMBER UPDATE:
The state government office that oversees QUEST Integration has restarted their renewals process.
Please be on the lookout for a pink envelope in the mail.  Visit medquest.hawaii.gov for more information.
Keep us informed of your current address and phone number. Call us at 1-877-973-0712 if you have any questions.

Plan Publications

Find any publications and information that AlohaCare has available to you.

 

  1. QUEST Integration Provider Manual
  2. Medicare Provider Manual
  3. QUEST Integration Provider & Pharmacy Directory
  4. QUEST Integration Benefits
  5. Provider Quick Reference Guide
  6. QUEST Integration Primary Billing Payer Sheet
  7. QUEST Integration Secondary Billing OPAP Payer Sheet
  8. QUEST Integration Secondary Billing OPPR Payer Sheet
  9. Provider Enhancement Program

2024 Provider Advisories

 

April: AlohaCare's Guideline Transparency

April: FDA Drug Safety Communication - Boxed warning on prescription stimulants for serious risk of misuse, abuse, & addiction

April: FDA Drug Safety Communication - Warning on levetiracetam and clobazam combo for increased risk of rare, but serious hypersensitivity reactions

April: FDA Drug Safety Communication - Preliminary evaluation of GLP-1 RA's does not suggest causal link to reports of suicidal thoughts/actions

April: FDA Drug Safety Communication - Boxed warning on Prolia (denosumab) for increased risk of severe hypocalcemia in advanced CKD

2023 Provider Advisories

 

April: Proton Pump Inhibitors 

June: Medication Adherence

June: Supplemental Diagnosis Submission

July: Palliative Care Program

July: Additional Guidance For Safe Use Of Opioids

August: Weight Management Drugs Advisory

August: Emergency Management Notification

August: Non-Emergency Air Ambulance Prior Authorization Notification

September: Emergency Management Notification

October: New Plan, AlohaCare Advantage Plus, Combines Medicaid (QUEST Integration) and Medicare Coverage into One Plan

October: Medicare Drug Prior Authorization (PA) - Ease of Getting Needed Prescription Drugs 

October: Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program Training Sessions

October: Emergency Management Notification 

December: Cologuard

 

2024 provider newsletters

Quarter 1 2024 

 

2023 Provider Newsletters

Quarter 1 2023 

Quarter 2 2023

Quarter 3 2023

Quarter 4 2023

2022 Provider Advisories

January: Inappropriate Use of Ivermectin for COVID-19

January: Electronic Prior Authorizations (ePA)

January: FDA requires warning about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions

February: Tips for Prior Authorizations (PA) Submission for Pharmacy Benefits

February: New AlohaCare E-Consult (Curbside Consult) Program for QUEST Integration for PCPS (MD, PA, APRN) and Specialists (MD, DO)

March: Warning About Potential Abuse of Ioperamide (Imodium) 

March: FDA investigating possible increased risk of death with lymphoma medicine Ukoniq (umbralisib) 

March: Buprenorphine sublingual usage associated with dental problems

June: AlohaCare APR DRG Billing Guide

July: FDA warns about possible increased risk of death and serious side effects with cancer drug Copiktra (duvelisib)

July: FDA approval of lymphoma medicine Ukoniq (umbralisib) is withdrawn due to safety concerns

October: Transmucosal Immediate Release Fentanyl (TIRF)

November: IngenioRx will become CarelonRx on January 1, 2023

December: FDA investigating risk of severe hypocalcemia in patients on dialysis receiving osteoporosis medicine Prolia (denosumab)

December: 2023 Medicare Benefit Update

2022 Provider Newsletters

Quarter 4 2022

Quarter 3 2022

Quarter 2 2022

Quarter 1 2022

 

2021 Provider Advisories

January: Acupuncture

January: Hawaii's Vaccination Plan

January:  Medicaid Eligibility For Freely Associated States Under The Compact Of Free Association (COFA) Citizens

February: COVID-19 Pandemic-Related Flexibilities Offered by Med-QUEST

February: Non-Emergent Medical Transportation (NEMT) Scheduling Transitioning To IntelliRide - Updated: 3/24/21

April: Community Care Foster Family Home (CCFFH) and Expanded Adult Residential Care Home (EARCH) - IMPORTANT CLAIMS SUBMISSION UPDATES

April: FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later

April: Studies show increased risk of heart rhythm problems with seizure and mental health medicine (Lamictal) in patients with heart disease

April: FDA warns about serious problems with high doses of the allergy medicine Benadryl

May:  New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

June: REMINDER: New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

July: REMINDER: Provider Relief Fund Post-payment Reporting Requirements

July: FDA restricts use of Ocaliva in PBC patients with advanced cirrhosis 

July: FDA warns that abuse and misuse of the nasal decongestant propylhexedrine causes serious harm

July: FDA requests removal of strongest warning against cholesterol-lowering statins during pregnancy

September: Prior Authorization Changes for Specific Durable Medical Equipment (DME)

October: Buprenorphine for Chronic Pain

October:  Safe Opioid Prescribing Practices

December: Important New PBM Implementation - Update 

2021 Provider Newsletters

 

Quarter 4 2021

Quarter 3 2021

Quarter 2 2021

Quarter 1 2021

 

Pharmacy Communications

March: 100 Days Supply Coverage for Medicare Maintenance Drugs

May: Diabetic Testing Supplies

June: New Implementation - IngenioRx and CVS Caremark

September: Important Information for Claims Processing

September: Coordination of Benefits Change

November: Medicare 2022 Formulary Impacts & Walgreens Added to QUEST Pharmacy Network

December: CVS Caremark to process claims for AlohaCare Advantage Plus (HMO SNP)

December: Important New PBM Implementation - Update

 

Provider Quick Reference Treatment Guides

Provider Archive 2014-2020