Notice of Changes to Prior Authorization Requirements -- November 2019

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

 

Pharmacy

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

 

Medical Policies/Clinical Guidelines

• Medical Policy and Clinical Guidelines Updates – November 2019*
• Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*
• Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*
• Updates to AIM Spine Surgery Clinical Appropriateness Guideline*
• Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

 

Other Important Updates

• Medicare and Medicaid News