Policy UpdatesMedicare AdvantageApril 11, 2024

Carelon Medical Benefits Management, Inc. updates

Effective on June 30, 2024, the following Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guideline updates for medical necessity review will apply for Anthem:

  • Genetic Testing:
    • Hereditary Cancer Testing
    • Carrier Screening in the Prenatal Setting and Preimplantation Genetic Testing
    • Genetic Testing for Inherited Conditions

Existing precertification requirements have not changed. Please share this notice with other members of your practice and office staff.

Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

NVBCBS-CR-050511-24-CPN49780

PUBLICATIONS: May 2024 Provider Newsletter