Anthem Blue Cross and Blue Shield clinical criteria updates for specialty pharmacy are available

Effective for dates of service on and after March 1, 2022, the following current clinical criteria were revised and might result in services that were previously covered but may now be found to be not medically necessary.

 

Access the clinical criteria document information.

 

The Anthem Blue Cross and Blue Shield (Anthem) 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 AIM Specialty Health_® (AIM) (AIM), a separate company.

 

ING-CC-0012	Brineura (cerliponase alfa)
ING-CC-0021	Fabrazyme (agalsidase beta)
ING-CC-0099	Abraxane (paclitaxel, protein bound)
ING-CC-0100	Istodax (romidepsin)
ING-CC-0125	Opdivo (nivolumab)
ING-CC-0128	Tecentriq (atezolizumab)

 

1421-1221-PN-GA