Medical drug benefit clinical criteria updates
On November 15, 2019, February 21, 2020, May 15, 2020, August 21, 2020, August 28, 2020, and September 24, 2020, the Pharmacy and Therapeutics (P&T) Committee approved clinical criteria applicable to the medical drug benefit for Anthem Blue Cross and Blue Shield (Anthem) and AMH Health, LLC (AMH Health). These policies were developed, revised or reviewed to support clinical coding edits.
The clinical criteria is publicly available on the provider websites, and the effective dates will be reflected in the Anthem Clinical Criteria Web Posting September and October 2020 and AMH Health Clinical Criteria web Posting September and October 2020. Visit clinical criteria to search for specific policies.
If you have questions or would like additional information, use this email.
February 2021 Anthem Maine Provider News