California
Provider Communications

Articles Category: State & Federal / Medicare

Title	Publication	Category	Date
Anthem Blue Cross (Anthem) working with Optum to collect medical records for risk adjustment	June 2020 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2020
Medical policies and clinical utilization management guidelines update	June 2021 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2021
2020 Medicare risk adjustment provider trainings	June 2020 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2020
Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness	May 2021 Anthem Blue Cross Provider News - California	Medicare	May 1, 2021
Reminders for Medicare Advantage group retiree PPO plans and national access plus FAQ	June 2021 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2021
Diabetes HbA1c < 8 HEDIS guidance	June 2020 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2020
Maximizing efficient, high quality COVID-19 screenings	May 2021 Anthem Blue Cross Provider News - California	Medicare	May 1, 2021
Benefits update for Special Supplemental Benefits for the chronically ill	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
Modifier use reminders	June 2020 Anthem Blue Cross Provider News - California	Medicare	Jun 1, 2020
Helping our members	May 2021 Anthem Blue Cross Provider News - California	Medicare	May 1, 2021
Prior authorization requirements for CardioMEMs	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
Rehabilitative services prior authorization review update	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
California’s Valued Trust offers a Medicare Advantage option	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
CMS reminder: expedited/urgent requests	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
Personal Home Helper benefit	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
Bill Medicare Part D for shingles or tetanus vaccination claims	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
Nonpreferred products and corresponding preferred alternatives	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
New MA Opioid Treatment Program benefit	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
2019 Enhanced Personal Health Care program releases myFHR	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
Reminder: Mid-level practitioners are required to file using their NPI	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
Medical Policies and Clinical Utilization Management Guidelines update	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement (APM ID 0037943)	March 2020 Anthem Blue Cross Provider News - California	Medicare	Mar 1, 2020
Prior authorization requirements: new 2020 codes for coverage and precertification	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
New reimbursement policy: Update drug screen testing	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
2020 Medicare risk adjustment provider trainings	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
Electronic submission is preferred method for requesting pharmacy prior authorization	November 2019 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2019
Medical drug benefit Clinical Criteria updates for November 2019	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
Medical drug benefit Clinical Criteria updates for December 2019	April 2020 Anthem Blue Cross Provider News - California	Medicare	Apr 1, 2020
Fall prevention tips	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Medical records request for risk adjustment	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Medicare Advantage reimbursement policy provider bulletin	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Important update on Botox® for Medicare members of Anthem Blue Cross	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
Partial hospitalization services	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Los Angeles City Employees’ Retirement System adds the medical and prescription drug plan	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
New incentive program reimbursement for select CPT Category II codes	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Northern California Cement Masons, California moves to Medicare Advantage plan	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
Prior authorization requirements for DME repair and portable oxygen concentrator	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Professional claims – billing referring provider and NPI for home infusion therapy and ambulatory infusion suite	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
Update: Evaluation and management with Modifier 25	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
Keep up with Medicare news	May 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	May 1, 2019
Keep up with Medicare news – January 2022 AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update Medical step therapy updates Anthem Blue Cross expands specialty pharmacy precertification list	January 2022 Anthem Blue Cross Provider News - California	Medicare	Jan 1, 2022
Preventing claims denials: Shingles vaccine Know best: Shingles vaccinations are a Medicare Part D benefit whether administered in your office or in the pharmacy.	August 2021 Anthem Blue Cross Provider News - California	Medicare	Aug 1, 2021
Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907	August 2021 Anthem Blue Cross Provider News - California	Medicare	Aug 1, 2021
Infliximab Step Therapy – effective July 15, 2021	August 2021 Anthem Blue Cross Provider News - California	Medicare	Aug 1, 2021
New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing Providers Nationally Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.	New 240k member Medicare Advantage Group Retiree PPO plan	Medicare	Oct 19, 2021
PN for UM AROW Item 1330	February 2021 Anthem Blue Cross Provider News - California	Medicare	Feb 1, 2021
IBEW Local 234, CA moves to Medicare Advantage plan under Anthem Blue Cross	February 2021 Anthem Blue Cross Provider News - California	Medicare	Feb 1, 2021
Medical drug benefit Clinical Criteria updates	September 2020 Anthem Blue Cross Provider News - California	Medicare	Sep 1, 2020
Medical drug benefit Clinical Criteria updates	February 2021 Anthem Blue Cross Provider News - California	Medicare	Feb 1, 2021
Prior authorization requirements for the below codes	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Evaluation and management services correct coding	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Medical drug benefit Clinical Criteria updates	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
In-office assessment program	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
May 2020 medical policies and clinical utilization management guidelines update	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Patient360 enhancement for medical providers	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Coming soon, electronic attachments	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Prior authorization requirements for the below codes	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Prior authorization requirements for Global March MPTAC CCRT configuration	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Update: Notice of changes to the AIM musculoskeletal program	October 2020 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2020
Aspire Telehealth Palliative Care program	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Clinical laboratory improvement amendments for Anthem Blue Cross	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Los Angeles Unified School District (LAUSD) Offers Medicare Advantage Option	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
Reminder: Anthem follows original Medicare policies	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
Use grouped CPT codes for AIM Specialty Health authorizations	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
New reimbursement policy – Modifier 90: Reference (outside) laboratory and pass-through billing	July 2021 Anthem Blue Cross Provider News - California	Medicare	Jul 1, 2021
MA members receive incentives for completing screenings	August 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Aug 16, 2018
Anthem eye refraction and routine eye exam billing information	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
Let’s vaccinate Help increase your vaccination rates and close gaps-in-care with these tools and strategies	July 2021 Anthem Blue Cross Provider News - California	Medicare	Jul 1, 2021
DME providers and physicians: important wheelchair prior authorization information	August 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Aug 16, 2018
New specialty Medicare Part B device preferred product program	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428	July 2021 Anthem Blue Cross Provider News - California	Medicare	Jul 1, 2021
Submit PA medication requests electronically; new phone number for MA prescription PAs	August 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Aug 16, 2018
Keep up with Medicare news	February 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Feb 1, 2019
March 2021 Medical drug benefit clinical criteria updates	July 2021 Anthem Blue Cross Provider News - California	Medicare	Jul 1, 2021
CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019	August 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Aug 16, 2018
March 2019 medical policies and clinical utilization management guidelines update	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Attention facilities: Sending admission, discharge and transfer data to Anthem Blue Cross results in improved care management for patients	July 2021 Anthem Blue Cross Provider News - California	Medicare	Jul 1, 2021
Keep up with Medicare news	August 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Aug 16, 2018
June 2019 medical policies and clinical utilization management guidelines update	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Update: 2019 risk adjustment provider trainings	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Medicare preferred continuous glucose monitors	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Lowering health risks with no-cost statins	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
Convenient, reliable at-home testing for colorectal cancer and diabetes care	May 2022 Anthem Blue Cross Provider News - California	Medicare	May 1, 2022
Medical drug clinical criteria updates	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
New Strategic Provider System implementation May 2022	May 2022 Anthem Blue Cross Provider News - California	Medicare	May 1, 2022
Assisting your patients in managing the Donut Hole	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
HEDIS 2022: Summary of changes from NCQA	May 2022 Anthem Blue Cross Provider News - California	Medicare	May 1, 2022
Prior authorization requirements for continuous positive airway pressure supplies	October 2019 Anthem Blue Cross Provider News - California	Medicare	Oct 1, 2019
New specialty pharmacy medical step therapy requirements	May 2022 Anthem Blue Cross Provider News - California	Medicare	May 1, 2022
Genetic testing prior authorization by ordering physician helps ensure accurate lab payment	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
Anthem transitions MA back pain management and cardiology UM programs from OrthoNet to AIM	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
Please evaluate statin use for MA members with diabetes, cardiovascular disease	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
Medicare pharmacy and prescriber home starts January 2019	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
CalPERS Medicare Advantage plan members to receive new ID cards	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019	December 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Dec 1, 2018
Keep up with Medicare news	October 2018 Anthem Blue Cross Provider Newsletter - California	Medicare	Oct 1, 2018
Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred	April 2019 Anthem Blue Cross Provider Newsletter - California	Medicare	Apr 1, 2019
Prior authorization requirements for the below codes	November 2020 Anthem Blue Cross Provider News - California	Medicare	Nov 1, 2020

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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use.