Clinical criteria updates for specialty pharmacy
Effective for dates of service on and after March 1, 2019, the following new clinical criteria will be included in our clinical criteria review process. The drugs that require prior authorization will continue to require prior authorization notification with AIM.
Existing prior authorization requirements have not changed for the specific Clinical Criteria below. 9*-+While there are no material changes, the document number and online location has changed. To access the clinical criteria information please click here. The attached PDF includes a table that will assist you in identifying the new document number for the clinical criteria that corresponds with the previous Clinical Guideline/Medical Policy.
Anthem’s pre-service clinical review of these specialty pharmacy drugs will be managed by AIM Specialty Health® (AIM), a separate company.
See attached PDF titled “Clinical criteria updates for specialty pharmacy clinical criteria and Clinical Guideline/Medical Policy table”.
March 2019 Anthem Provider Newsletter - Georgia