Notification of specialty pharmacy medical step therapy updates

Effective for dates of service on and after December 1, 2023, updated step criteria for Iron Agents found in Clinical Criteria document CC-0182 will be implemented. The preferred product list is being expanded. Please refer to the Clinical Criteria page for more information.

Clinical UM Guidelines are publicly available on the care provider website. Visit the Clinical Criteria page to search for specific criteria.

We’re committed to active involvement with our care provider partners and going beyond the contract to create a real impact on the health of our communities.