Notice of Changes to Prior Authorization Requirements - May 2019

New prior authorization requirements for providers and/or material changes to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements for articles starred (*) below.

 

Medical Policies and Clinical Guidelines

 

• Clinical Guidelines Updates – May 2019*

 

• Anthem MCG Care Guidelines – 23rd Edition*

 

Reimbursement Policies

 

• Update: Drug Screen Testing – Professional*

 

Pharmacy Updates

 

• Anthem expands specialty pharmacy medical step therapy drug list for agents for hereditary angioedema*

 

• Anthem specialty pharmacy medical step therapy drug list clarification about non oncology colony stimulating factor agents*

 

 Other Important Updates

 

• Medicare and Medicaid News