Notices of material changes/amendments to contract – October 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:

• Change to NEHP prior authorization requirements for certain Carelon Medical Benefits Management, Inc. programs
• Clinical Criteria Updates - June 2023
• Medical Policy and Clinical Guideline updates
• Specialty pharmacy updates — October 2023
• Reimbursement policy update: After-Hours, Emergency, and Miscellaneous E/M Services – Professional
• Transition to Carelon Medical Benefits Management, Inc. site of care guidelines