CommercialMedicare AdvantageMedicaidMarch 1, 2024

March 2024 Provider Newsletter

Administrative

AdministrativeCommercialMarch 1, 2024

CAA: Maintain your online provider directory information

AdministrativeCommercialMarch 1, 2024

Timely access regulations and language assistance program

Digital SolutionsMedicare AdvantageFebruary 29, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Digital SolutionsCommercialFebruary 26, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingMedicare AdvantageFebruary 1, 2024

2024 Medicare Advantage California EAE DSNP changes

Education & TrainingCommercialMedicaidMarch 1, 2024

Congenital syphilis intervention opportunities for neonatal and pediatric providers

Education & TrainingMedicaidMarch 1, 2024

Resources to support your diverse patient panel

Policy Updates

Policy UpdatesMedicare AdvantageFebruary 13, 2024

MCG Care Guidelines 27th edition update

Medical Policy & Clinical GuidelinesMedicaidFebruary 21, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Medical Policy & Clinical GuidelinesMedicare AdvantageFebruary 20, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 1, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationMedicare AdvantageJanuary 24, 2024

Prior authorization requirement changes effective May 1, 2024

Code C1825

Prior AuthorizationMedicare AdvantageFebruary 1, 2024

Prior authorization requirement changes effective May 1, 2024

Codes G0481 - G0483

Products & Programs

PharmacyMedicaidFebruary 21, 2024

Prior authorization updates for medications billed under the medical benefit

PharmacyCommercialMarch 1, 2024

Important information about your Anthem patients’ Botox prescriptions

PharmacyCommercialMarch 1, 2024

Pharmacy information available on our provider website

PharmacyMedicare AdvantageFebruary 16, 2024

Anthem expands specialty pharmacy precertification list

PharmacyMedicare AdvantageMarch 1, 2024

Overview of Medicare risk adjustment in-office prospective programs

PharmacyMedicare AdvantageJanuary 31, 2024

Notification of specialty pharmacy medical step therapy updates

Quality Management

Quality ManagementCommercialMedicaidMarch 1, 2024

Encourage Cervical Cancer Screening (CCS)

Quality ManagementCommercialMedicaidMarch 1, 2024

Cervical Cancer Screening (CCS) and Prenatal and Postpartum Care (PPC) for HEDIS

Quality ManagementMedicare AdvantageFebruary 6, 2024

HEDIS® 2024 documentation for Care of Older Adults (COA)

Quality ManagementCommercialMedicare AdvantageMedicaidFebruary 6, 2024

HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC)

Quality ManagementCommercialMedicare AdvantageMedicaidJanuary 29, 2024

HEDIS Breast Cancer Screening (BCS) update

Quality ManagementCommercialMarch 1, 2024

Boost annual preventive care visits: Tips and resources: An ounce of prevention is worth a pound of cure

CABC-CDCRCM-051131-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).