Notice of Changes to Prior Authorization Requirements - December 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

 

Changes to Prior Authorization Requirements

 

• Prior authorization updates for specialty pharmacy are available*
  
  
• Medical Policy update*
  
  
• Updates to AIM Cardiology clinical appropriateness guidelines*
  
  
• Updates to AIM Advanced Imaging clinical appropriateness guidelines*
  
  
• Updates to AIM Radiation Oncology clinical appropriateness guidelines*
  
  
• Reimbursement policy update: Bundled services and supplies (Professional)*
  
  
• Reimbursement policy update: DRG newborn inpatient stays (Facility)*