Changes to Prior Authorization Requirements and/or Material Changes to Contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

Clinical Guidelines

  • Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*



  • Clinical Validation: Professional*
  • Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*


Other Important Updates

  • Pharmacy: Clinical Criteria updates for specialty pharmacy
  • FEP: Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care


Medicare and Medicaid News


Featured In:
July 2019 Anthem Provider News - Indiana