Effective March 1, 2022, the following Part B medications from the current Clinical Utilization Management (UM) Guidelines will be included in our medical step therapy precertification review process. Step therapy review will apply upon precertification initiation, in addition to the current medical necessity review (as is current procedure). Step therapy will not apply for members who are actively receiving medications listed below.

 

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

 

Clinical UM Guidelines

Preferred drugs

Nonpreferred drugs

ING-CC-0062

Inflectra, Remicade, Infliximab (unbranded)

Avsola, Renflexis

 

ABSCARE-1286-22

AMHCARE-0526-22



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May 2022 Anthem New Hampshire Provider News