CommercialJuly 1, 2021

July 2021 Anthem Provider News - Indiana

Policy Updates

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2021

Reminder: Updated AIM rehabilitative program effective August 1, 2021 - Site of service reviews

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2021

Medical Policy and Clinical Guideline Updates - July 2021*
*Change to Prior Authorization Requirements

Reimbursement PoliciesCommercialJuly 1, 2021

Reimbursement policy update: Consultations - Professional*
IN: *Change to Prior Authorization Requirements

Reimbursement PoliciesCommercialJuly 1, 2021

New reimbursement policy: Non-patient laboratory services - Facility*
*Change to Prior Authorization Requirements

Products & Programs

Products & ProgramsCommercialJuly 1, 2021

Reminder: Back Pain Guide program effective July 19, 2021

Products & ProgramsCommercialJuly 1, 2021

Company to retire Blue Precision program at the end of the year

PharmacyCommercialJuly 1, 2021

Certain specialty medication prior authorization requests may require additional documentation*
*Change to Prior Authorization Requirements

PharmacyCommercialJuly 1, 2021

Updates for specialty pharmacy are available - July 2021*
*Change to Prior Authorization Requirements

PharmacyCommercialJuly 1, 2021

Designated specialty pharmacy network updates effective October 1, 2021*
*Change to Prior Authorization Requirements

State & Federal

State & FederalMedicare AdvantageJuly 1, 2021

Medical drug benefit clinical criteria updates

State & FederalMedicare AdvantageJuly 1, 2021

Let’s Vaccinate

State & FederalMedicare AdvantageJuly 1, 2021

Medicare News - July 2021
View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Member Rights and Responsibilities Statement

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Important information about utilization management

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Complex Case Management program

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Provider education program survey: Your Voice Counts

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Continuing medical education/continuing education unit opportunities

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2021

Medicaid News - July 2021
View these Medicaid articles:
- Aspire Health for members in need of palliative care
- August 2020 Medical Policies and Clinical Utilization Management Guidelines update