Notice of Changes to Prior Authorization Requirements -- September 2019

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

Clinical Guidelines

• Clinical Guideline Updates*

 

Reimbursement Policies

• New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*
• New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery – Professional*

 

Pharmacy Updates

• Clinical criteria and prior authorization updates for specialty pharmacy are available*

 

Other Important Updates

• Medicare and Medicaid News