California
Provider Communications
New specialty pharmacy medical step therapy requirements
Also, effective for dates of service on or after January 1, 2023, Feraheme (ferumoxytol) will change to preferred for both brand and generic.
Step therapy review will apply upon precertification initiation, in addition to the current medical necessity review (as is current procedure). Step therapy will not apply for members who are actively receiving medications listed below.
Clinical UM Guidelines are publicly available on the provider website. Visit the Clinical Criteria page to search for specific criteria.
Clinical UM Guidelines |
Preferred drug(s) |
Nonpreferred drug(s) |
ING-CC-0182 |
Feraheme (ferumoxytol) Ferrlecit (sodium ferric gluconate/sucrose complex) Venofer (iron sucrose) |
Infed (iron dextran) Injectafer (ferric carboxymaltose) Monoferric (ferric derisomaltose) |
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February 2023 Anthem Blue Cross Provider News - California