MedicaidDecember 31, 2019
Medical drug benefit Clinical Criteria updates - August 2019
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
This communication applies to the Medicaid and Medicare Advantage programs for Empire BlueCross BlueShield (Empire).
On August 16, 2019, the Pharmacy and Therapeutics (P&T) Committee approved Clinical Criteria applicable to the medical drug benefit for Empire. 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 Web Posting August 2019. Visit Clinical Criteria to search for specific policies.
For questions or additional information, use this email.
PUBLICATIONS: January 2020 Empire Provider News
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