Ambulatory Surgical Center (ASC) Quarterly Update File - October 20, 2025

Due to the ongoing federal government shutdown, the Ambulatory Surgical Center (ASC) quarterly update file for October 2025 has been delayed by the Centers for Medicare and Medicaid Services (CMS). This file did not meet Blue Cross of Idaho’s timeline for implementation.

The July 2025 quarterly update file from CMS was also delayed and missed Blue Cross of Idaho’s cutoff for timely processing. This file will be included in the October quarterly update.

Any CMS files released in late October will be incorporated into the January 2026 quarterly update, unless a replacement file becomes available.

Blue Cross of Idaho appreciates your understanding and will continue to monitor CMS releases closely to ensure timely updates in accordance with MA PAP250 – Quarterly Maximum Allowance Updates. 

Upcoming Medicare Advantage Plan Changes- October 9, 2025

We are pleased to provide important updates to our Medicare Advantage (MA) plans for the 2026 plan year, effective January 1, 2026. The changes are designed to allow us to continue offering high quality MA plan options to our members in a sustainable way. We are developing training material and resources to help you better understand these changes. These resources will be available begininning November 1, 2025, to help you prepare for the changes in 2026.

New MA Plan options: Nearly all our MA plans will be new, which means all members will need to select a new plan that meets their needs.

Plan Availability: 

96% of our current MA members will be able to select a Blue Corss of Idaho MA plan in 2026.

Since plan offerings vary by county, some MA plans will not be available in certain counties.

Medicare Supplmental plans will be available statewide.

Members will be able to select MA plans beginnning on October 15, 2025.

Strengthening Primary Care: All MA MA members will be asked to establish care with a primary care provider (PCP). This creates stronger patient-provider relationships, supports care coordination and improves long-term health outcomes. Additionally, all 2026 plans will require referrals for specialty care.

Every MA member will need to select a PCP at enrollment.

What providers should know: With these changes, it’s important for provider practices to be aware of plan updates and re-enrollment timelines, as well as the benefits of strengthened PCP relationships.

The specific referral requimrents for a member to be seen by a specialist will be further communicated in detail, on November 1, 2025.

We appreciate your partnership in making this transition smooth and successful for our shared patients.