Kentucky
Provider Communications
Medical Policies and Clinical Utilization Management Guidelines Update -- June 2019
Please share this notice with other members of your practice and office staff.
To search for specific policies or guidelines, visit https://www11.anthem.com/search.html.
Updates:
- The InterQual 2019 version release takes effect on May 1, 2019.
Medical Policies
On November 21, 2018, the Medical Policy and Technology Assessment Committee (MPTAC) approved the following Medical Policies applicable to Anthem Blue Cross and Blue Shield Medicaid (Anthem).
|
Publish date |
Medical Policy # |
Medical Policy title |
New or revised |
|
12/12/2018 |
DRUG.00090 |
Bezlotoxumab (ZINPLAVA™) |
Revised |
|
11/15/2018 |
DRUG.00046 |
Ipilimumab (Yervoy®) |
Revised |
|
11/15/2018 |
DRUG.00075 |
Nivolumab (Opdivo®) |
Revised |
|
12/12/2018 |
DRUG.00062 |
Obinutuzumab (Gazyva®) |
Revised |
|
11/15/2018 |
DRUG.00071 |
Pembrolizumab (Keytruda®) |
Revised |
Clinical UM Guidelines
On November 21, 2018, the MPTAC approved the following Clinical UM Guidelines applicable to Anthem. These guidelines were adopted by the medical operations committee for Anthem Blue Cross and Blue Shield Medicaid members on January 3, 2019.
|
Publish date |
Clinical UM Guideline # |
Clinical UM Guideline title |
New or revised |
|
11/15/2018 |
CG-DRUG-88 |
Dupilumab (Dupixent®) |
Revised |
|
12/12/2018 |
CG-DRUG-107 |
Pharmacotherapy for Hereditary Angioedema |
Revised |
|
12/12/2018 |
CG-DRUG-63 |
Levoleucovorin Products Previously title: Levoleucovorin Calcium (Fusilev®) |
Revised |
|
12/12/2018 |
CG-DRUG-65 |
Tumor Necrosis Factor Antagonists |
Revised |
|
12/12/2018 |
CG-DRUG-78 |
Antihemophilic Factors and Clotting Factors |
Revised |
AKY-NU-0143-19
Featured In:
June 2019 Anthem Provider Newsletter - Kentucky