Notice of Changes to Prior Authorization Requirements - March 2021

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.

 

Changes to Prior Authorization Requirements

• Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021
• Updates for specialty pharmacy are available – March 2021
• Some HIV medication combinations may require prior authorization
• Anthem clarifies guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNF) facilities
• New reimbursement policy update: Place of Service Evaluation and Management – Facility
• Update: Notice of changes to the AIM Small Joint Surgery guideline