Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

 

  • Medical Policy/Clinical Guidelines Updates – February 2019*

 

  • Reimbursement Policy Updates – February 2019*

 

  • Clinical criteria updates for specialty pharmacy*

 

  • Specialty pharmacy prior authorization list expansion*

 

  • Specialty pharmacy medical step therapy drug list expansion*

 

  • Professional billing - Update regarding E/M with modifier 25

 

  • Medicare and Medicaid updates



Featured In:
February 2019 Anthem Ohio Provider Newsletter