State & FederalMedicaidAugust 31, 2019

Clinical Criteria updates

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Category: Medicaid

On March 29, 2019, April 12, 2019 and May 1, 2019, the Pharmacy and Therapeutic (P&T) Committee approved Clinical Criteria applicable to the medical drug benefit for Empire BlueCross and BlueShield. These policies were developed, revised or reviewed to support clinical coding edits.

 

The Clinical Criteria is publicly available on the provider website, and the effective dates will be reflected in the Clinical Criteria Q2 update. Visit Clinical Criteria to search for specific policies.

 

For questions or additional information, use this email.

 

NYE-NU-0153-19 July 2019

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