Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

 

Medical Policies and Clinical Guidelines

  • Medical Policy and Clinical Guideline Updates - June 2019*
  • New Clinical Guideline: Inpatient Inter-Facility Transfers effective September 1, 2019*

 

Reimbursement Policies

  • New Reimbursement Policy: Ambulance Transportation – Professional*
  • Reimbursement Policy Update: Frequency Editing – Professional*
  • Reimbursement Policy Update: Clinical Validation – Professional [KY only]*

 

Pharmacy Updates

  • Anthem expands specialty pharmacy prior authorization list*
  • Anthem announces changes in medical non-oncology specialty drug reviews effective June 15, 2019

 

Other Important Updates

  • AIM programs may require additional prior authorization documentation
  • Medicare and Medicaid News

 



Featured In:
June 2019 Anthem Provider Newsletter - Kentucky