Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageDecember 1, 2024

December 2024 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — December 2024

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 1, 2024

Roster Automation updates: roster download functionality


Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Important information about utilization management

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Case Management program

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

PCP after‑hours access requirements

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Coordination of care

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Clinical practice and preventive health guidelines available online

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Maine 2025 Medicare Advantage plan changes

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 15, 2024

Skilled nursing facility — vaccine serum compensation

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Members’ Rights and Responsibilities

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Behavioral Health

Behavioral HealthAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageDecember 1, 2024

Comprehensive, holistic care for obstructive sleep apnea

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Notice of change: Part D Rx HCCs

Policy Updates

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 30, 2024

Clinical Criteria updates

Effective December 2, 2024

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Notice of material change/amendment to contract

New reimbursement policy: Trauma Activation — Facility

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialNovember 21, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

FEP excited to join PSHB program in 2025

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 18, 2024

Notice of material change/amendment to contract

Specialty pharmacy updates — December 2024

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Pharmacy information available online

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Kroger Specialty Pharmacy acquisition

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Paragon Healthcare joins our medical specialty pharmacy provider network in 2025

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 14, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

MEBCBS-CRCM-072817-24

For questions regarding Commercial plans in Maine, call Provider Services at 833-690-2936.