Medicare AdvantageJanuary 18, 2024
RETRACTED: Expansion of specialty pharmacy precertification list
This article was published in error and retracted on February 23, 2024. Please access the updated version here.
Effective for dates of service on and after May 1, 2024, the specialty Medicare Part B drugs listed in the table below will be included in our precertification review process.
Federal and state law, as well as state contract language and CMS guidelines (including definitions and specific contract provisions/exclusions), take precedence over these precertification rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.
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Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
CABC-CR-046705-23-CPN45768
PUBLICATIONS: February 2024 Provider Newsletter
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