California
Provider Communications

February 2021 Anthem Blue Cross Provider News - California

Title	Category
Pharmacy information available on anthem.com/ca	Pharmacy
Anthem Blue Cross to update formulary lists for commercial health plan pharmacy benefit	Pharmacy
Reminder: Effective January 2021, all NECA/IBEW have new member ID numbers	Administrative
New provider directory indicator for telehealth services	Administrative
New utilization management tool now available on Availity Payer Spaces: Authorization Rules Lookup tool	Administrative
Anthem continues to offer EPO and HMO individual on and off exchange products Expansion of both EPO and HMO offerings to new regions.	Administrative
Anthem Blue Cross provider directory and provider data updates	Administrative
Easily update provider demographics with the online Provider Maintenance Form	Administrative
Provider Education seminars, webinars, workshops and more!	Administrative
Stay “in the know” at no charge!	Administrative
Network leasing arrangements	Administrative
Reimbursement Policy update – effective May 1, 2021 Preadmission Services for Inpatient Stays	Medi-Cal Managed Care
CAHPS® survey	Medi-Cal Managed Care
HEDIS Measurement year 2020: Medi-Cal summary of changes from NCQA	Medi-Cal Managed Care
Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326	Medi-Cal Managed Care
Update to Clinical Practice Guidelines and Preventive Health Care Guidelines	Medi-Cal Managed Care
Updated quality performance requirements	Medi-Cal Managed Care
Prior authorization requirements for 55899	Medi-Cal Managed Care
Radiotherapies and radioimmunotherapies will require prior authorization	Medi-Cal Managed Care
Medical drug benefit Clinical Criteria updates	Medi-Cal Managed Care
Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards New additional benefit detail.	Medi-Cal Managed Care
New specialty pharmacy medical step therapy requirements	Medi-Cal Managed Care
PN for UM AROW Item 1330	Medicare
IBEW Local 234, CA moves to Medicare Advantage plan under Anthem Blue Cross	Medicare
Medical drug benefit Clinical Criteria updates	Medicare
Medical drug benefit Clinical Criteria updates – August 2020	Cal MediConnect
Medical drug benefit Clinical Criteria updates	Cal MediConnect

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California
Provider Communications

February 2021 Anthem Blue Cross Provider News - California

Pharmacy information available on anthem.com/ca

Anthem Blue Cross to update formulary lists for commercial health plan pharmacy benefit

Reminder: Effective January 2021, all NECA/IBEW have new member ID numbers

New provider directory indicator for telehealth services

New utilization management tool now available on Availity Payer Spaces: Authorization Rules Lookup tool

Anthem continues to offer EPO and HMO individual on and off exchange products

Anthem Blue Cross provider directory and provider data updates

Easily update provider demographics with the online Provider Maintenance Form

Provider Education seminars, webinars, workshops and more!

Stay “in the know” at no charge!

Network leasing arrangements

Reimbursement Policy update – effective May 1, 2021

CAHPS® survey

HEDIS Measurement year 2020: Medi-Cal summary of changes from NCQA

Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326

Update to Clinical Practice Guidelines and Preventive Health Care Guidelines

Updated quality performance requirements

Prior authorization requirements for 55899

Radiotherapies and radioimmunotherapies will require prior authorization

Medical drug benefit Clinical Criteria updates

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards

New specialty pharmacy medical step therapy requirements

PN for UM AROW Item 1330

IBEW Local 234, CA moves to Medicare Advantage plan under Anthem Blue Cross

Medical drug benefit Clinical Criteria updates

Medical drug benefit Clinical Criteria updates – August 2020

Medical drug benefit Clinical Criteria updates

CaliforniaProvider Communications

February 2021 Anthem Blue Cross Provider News - California

California
Provider Communications