Georgia
Provider Communications
Clinical Criteria updates for specialty pharmacy are available
Effective for dates of service on and after May 1, 2023, the following Clinical Criteria were developed and might result in services that were previously covered but may now be found to be not medically necessary.
CC-0003 |
Immunoglobulins |
CC-0062 |
Tumor necrosis factor antagonists |
CC-0100 |
Istodax (romidepsin) |
CC-0168 |
Tecartus (brexucabtagene autoleucel) |
CC-0205 |
Fyarro (siroliumus albumin bound) |
Access the Clinical Criteria document information.
Anthem Blue Cross and Blue Shield (Anthem)’s prior authorization clinical review of non-oncology specialty pharmacy drugs will be managed by Anthem’s medical specialty drug review team. Drugs used for the treatment of oncology will be managed by Carelon Medical Benefits Management, Inc.,* a separate company.
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March 2023 Anthem Provider News - Georgia