Notices of material changes/amendments to contract – July 2023

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Provider data management capability now available on Availity Essentials — retirement of previous intake channels October 1, 2023
• Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers program
• Medical Policy and Clinical Utilization Management Guidelines updates
• Carelon Medical Benefits Management, Inc. genetic testing CPT code list update
• Authorizations for post-acute care services for Commercial members
• Clinical Criteria updates for specialty pharmacy
• Specialty pharmacy updates — July 2023