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62 results matching 1 active filter

Policy Updates Prior AuthorizationMedicare AdvantageJuly 9, 2025

Prior authorization requirement changes

Effective November 1, 2025

Policy Updates Prior AuthorizationCommercialMedicare AdvantageMedicaidJuly 1, 2025

Benefits of utilization management attestations: a guide for care providers

Education & TrainingMedicare AdvantageJune 17, 2025

2025 Medicare Advantage California EAE D‑SNP Fact Sheet

Education & TrainingCommercialMay 1, 2025

Streamline your prior authorizations with our digital tools

Policy Updates Prior AuthorizationMedicaidApril 4, 2025

Precertification/prior authorization requirement changes

Effective August 1, 2025

Policy Updates Prior AuthorizationMedicare AdvantageMarch 28, 2025

Outpatient preapproval update from Carelon Medical Benefits Management, Inc.

Policy Updates Prior AuthorizationMedicare AdvantageMarch 26, 2025

Prior authorization requirement changes

Effective July 1, 2025

Policy Updates Prior AuthorizationMedicaidMarch 20, 2025

Prior authorization requirement changes

Effective July 1, 2025

Policy Updates Prior AuthorizationMedicare AdvantageMarch 6, 2025

Prior authorization requirement changes
Effective July 1, 2025

Policy Updates Prior AuthorizationMedicaidNovember 5, 2024

Prior authorization requirement changes

Effective March 1, 2025

Policy Updates Prior AuthorizationMedicaidOctober 10, 2024

Prior authorization requirement changes

Effective February 1, 2025

Policy Updates Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Policy Updates Prior AuthorizationMedicare AdvantageSeptember 23, 2024

Prior authorization requirement changes

Effective January 1, 2025

Policy Updates Prior AuthorizationMedicare AdvantageSeptember 6, 2024

Changes to special supplemental benefits for the chronically ill eligibility requirements

Policy Updates Prior AuthorizationMedicaidAugust 5, 2024

Prior authorization requirement changes

Effective December 1, 2024
Codes: 33263, 64582, and C2616

Policy Updates Prior AuthorizationMedicare AdvantageJuly 31, 2024

Prior authorization requirement changes

Effective December 1, 2024

Policy Updates Prior AuthorizationMedicaidJune 27, 2024

Prior authorization requirement changes

Effective October 1, 2024
Code L5615

Policy Updates Prior AuthorizationMedicaidJune 20, 2024

Prior authorization requirement changes effective October 1, 2024

Codes L7510 and L7520

Policy Updates Prior AuthorizationMedicaidJune 17, 2024

Prior authorization requirement changes effective October 1, 2024

Code C9790

Policy Updates Prior AuthorizationMedicaidJune 11, 2024

Prior authorization requirement changes

Effective October 1, 2024
Codes 81173, 81247, 81249, 81307, 81336, 81403, 81405, and 81440

Policy Updates Medical Policy & Clinical GuidelinesMedicare AdvantageMay 2, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Policy Updates Prior AuthorizationMedicare AdvantageMarch 27, 2024

Requesting authorizations for post-acute care services

Policy Updates Prior AuthorizationMedicare AdvantageMarch 19, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Policy Updates Prior AuthorizationMedicare AdvantageMarch 11, 2024

Prior authorization requirement changes effective July 1, 2024

Policy Updates Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 1, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Policy Updates Prior AuthorizationMedicaidFebruary 29, 2024

Prior authorization requirement changes effective June 1, 2024

Policy Updates Prior AuthorizationMedicare AdvantageFebruary 1, 2024

Prior authorization requirement changes effective May 1, 2024

Codes G0481 - G0483

Education & TrainingMedicare AdvantageFebruary 1, 2024

2024 Medicare Advantage California EAE DSNP changes

Policy Updates Prior AuthorizationMedicare AdvantageJanuary 24, 2024

Prior authorization requirement changes effective May 1, 2024

Code C1825

Policy Updates Prior AuthorizationMedicare AdvantageJanuary 4, 2024

Long Term Acute Care (LTAC) Precertification Worksheet

Policy Updates Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Genetic testing code list update

Policy Updates Prior AuthorizationMedicaidDecember 18, 2023

Prior authorization requirement changes effective April 1, 2024

Code 20979

Policy Updates Prior AuthorizationMedicaidDecember 13, 2023

Prior authorization requirement changes effective April 1, 2024

Code J1411

Policy Updates Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 1, 2023

Glucagon-Like Peptide-1 prior authorization changes

Policy Updates Medical Policy & Clinical GuidelinesMedicare AdvantageNovember 17, 2023

Transition to Carelon Medical Benefits Management, Inc. Genetic Testing Guidelines

Policy Updates Prior AuthorizationMedicare AdvantageNovember 15, 2023

Prior authorization requirement changes effective May 1, 2024 


Codes 0738T and 0739T

Policy Updates Prior AuthorizationMedicare AdvantageNovember 15, 2023

Prior authorization requirement changes effective May 1, 2024 

Codes Q4272 - Q4284

Policy Updates Prior AuthorizationMedicare AdvantageNovember 8, 2023

Prior authorization requirement changes effective May 1, 2024 

Code E0761

Policy Updates Prior AuthorizationMedicare AdvantageOctober 31, 2023

Prior authorization requirement changes effective March 1, 2024 

Codes 33275 and 33274

Policy Updates Prior AuthorizationMedicaidOctober 24, 2023

Prior authorization update - Lamzede, Lunsumio, Rebyota, etc.

Policy Updates Prior AuthorizationMedicare AdvantageOctober 19, 2023

Expansion of Carelon Medical Benefits Management, Inc. programs

Policy Updates Prior AuthorizationMedicare AdvantageOctober 3, 2023

Prior authorization requirement changes effective February 1, 2024 - code J1411

Policy Updates Prior AuthorizationMedicaidAugust 9, 2023

Prior authorization requirement changes effective December 1, 2023

Policy Updates Prior AuthorizationMedicare AdvantageAugust 7, 2023

Prior authorization requirement changes effective December 1, 2023

Products & Programs PharmacyMedicaidAugust 1, 2023

PA update - Altuviiio

Policy Updates Prior AuthorizationMedicaidAugust 1, 2023

Fylnetra, Stimufend, and Rolvedon Medical Step Therapy Notice