Key Updates
Medicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploads
CommercialMedicare AdvantageMedicaid Managed CareAugust 25, 2025
Enhance your skills with expanded billing and coding training
Recent Updates
CommercialSeptember 1, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — September 2025Medicaid Managed CareSeptember 1, 2025
RSV immunization: key to infant healthMedicare AdvantageSeptember 1, 2025
Elevate your practice efficiency with electronic prescriber toolsMedicaid Managed CareSeptember 1, 2025
You are invited: provider orientation schedule for AnthemMedicaid Managed CareSeptember 1, 2025
You are invited: behavioral health provider orientationMedicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploadsMedicaid Managed CareSeptember 1, 2025
Behavioral health supervisor billing updateMedicare AdvantageSeptember 1, 2025
Medication safety: Reducing risks with thoughtful prescribing and monitoringMedicaid Managed CareSeptember 1, 2025
Joining Anthem for Next Generation MyCare OhioMedicaid Managed CareAugust 26, 2025
Upcoming prior authorizations for CPT codesEffective December 1, 2025
CommercialAugust 26, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
New guidelines for PET radiotracer management in UM beginning December 1, 2025CommercialAugust 26, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Carelon Medical Benefits Management, Inc. Additional Outpatient Utilization Management and SurgicalMedicaid Managed CareAugust 26, 2025
MCG Care Guidelines 29th Edition UpdatesEffective November 1, 2025
CommercialMedicare AdvantageMedicaid Managed CareAugust 25, 2025
Enhance your skills with expanded billing and coding trainingMedicare AdvantageAugust 25, 2025
Anthem expands specialty pharmacy precertification listsEffective December 1, 2025
Avtozma, Osenvelt, Osenvelt, Stoboclo, and Xbryk
Medicare AdvantageAugust 21, 2025
Medication safety: Clinical strategies for EMR monitoring and preventionMedicaid Managed CareAugust 18, 2025
Maternal and Infant Support Program started July 1, 2025Medicare AdvantageAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
CommercialAugust 14, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
Medicare AdvantageAugust 14, 2025
Precertification/prior authorization requirement changesEffective December 1, 2025
Medicaid Managed CareAugust 11, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective September 15, 2025
Medicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listEffective November 1, 2025
Bomyntra, Conexxence, Imaav, Jobevne, Omlyclo, Qfitlia, Vyalev, and Jobevne
CommercialAugust 1, 2025
SUD confidentiality protections for membersCommercialMedicare AdvantageMedicaid Managed CareAugust 1, 2025
You are invited: immunization measures webinarCommercialAugust 1, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Facility diagnostic radiopharmaceuticals and contrast mediaCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideMedicaid Managed CareAugust 1, 2025
Updated reimbursement procedure effective September 1, 2025Medicaid Managed CareJuly 25, 2025
Updated guidance: immunizations covered by VFCMedicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025Medicaid Managed CareJuly 24, 2025
Precertification/prior authorization requirement changesCommercialMedicare AdvantageJuly 23, 2025
Enhance care provider data accuracy with updated roster toolsCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideCommercialMedicare AdvantageJuly 18, 2025
New mandatory fields in roster templateCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataMedicaid Managed CareJuly 1, 2025
Reimbursement Policy Update: Multiple Radiology Payment ReductionCommercialJuly 1, 2025
View your Fee Schedule in Availity Essentials Payer SpacesCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsMedicaid Managed CareJuly 1, 2025
You are invited: Provider Engagement Council meeting