Policy UpdatesMedicaidMarch 26, 2024

Carelon Medical Benefits Management, Inc updates

Effective on June 30, 2024, the following Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guideline updates for medical necessity review will apply for Anthem:

  • Genetic testing:
    • Hereditary cancer testing
    • Carrier screening in the prenatal setting and preimplantation genetic testing
    • Genetic testing for inherited conditions

Existing precertification requirements have not changed. Please share this notice with other members of your practice and office staff.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

CABC-CD-050468-24-CPN49779

PUBLICATIONS: April 2024 Provider Newsletter