Products & Programs PharmacyCommercialSeptember 1, 2024

Clinical Criteria updates for specialty pharmacy

The following Clinical Criteria documents were endorsed at the June 10, 2024, Clinical Criteria meeting. Visit Clinical Criteria In Pharmacy to access the Clinical Criteria information.

New Clinical Criteria effective December 1, 2024

The following Clinical Criteria are new:

  • CC-0264 Anktiva (nogapendekin alfa inbekicept-pmln)

Revised Clinical Criteria effective December 1, 2024

The following Clinical Criteria were revised and might result in services that were previously covered but may now be found to be not medically necessary:

  • CC-0041 Complement C5 Inhibitors
  • CC-0166 Trastuzumab Agents

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-065215-24

PUBLICATIONS: September 2024 Provider Newsletter