Key Updates
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 11, 2025
Prior authorization requirement changes
Effective June 1, 2025
Anthem Blue Cross and Blue Shield | CommercialMarch 28, 2025
Streamline your workflow: Submit BH authorizations through Availity Essentials
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 28, 2025
Update: Availity launches enhanced provider enrollment features for improved efficiency
Recent Updates
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 25, 2025
Carelon Medical Benefits Management, Inc. updatesEffective June 15, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageApril 24, 2025
Medical Policies and Clinical Utilization Management Guidelines UpdateEffective May 25, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 19, 2025
Corrected ABA claim denials for codes 97152, 97153, and 97154Anthem Blue Cross and Blue Shield | Medicare AdvantageApril 18, 2025
New specialty pharmacy medical step therapy requirementEffective June 1, 2025
Hercessi
Anthem Blue Cross and Blue Shield | Medicare AdvantageApril 18, 2025
Specialty pharmacy preapproval list updateEffective August 1, 2025
Jubbonti; Wyost
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 16, 2025
Provider Training Opportunity: You are invited: strategies for enhancing cardiovascular care and managementAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 11, 2025
Submit preapproval requests for post‑acute care services for Medicare group retiree members to Carelon Post Acute SolutionsHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 11, 2025
Prior authorization requirement changesEffective June 1, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 4, 2025
Quarterly pharmacy formulary change noticeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 4, 2025
Quarterly pharmacy formulary change noticeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 3, 2025
Clinical Criteria updatesEffective May 7, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageApril 2, 2025
HEDIS measure: Statin Use in Persons with Diabetes (SUPD) 2025HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective May 1, 2025
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2025
Register for our next webinar: Enhancing Diabetes Management — Focus on Standardized MetricsHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 31, 2025
Virginia's Medical Preferred Drug List (PDL)/ Common Core FormularyAnthem Blue Cross and Blue Shield | CommercialMarch 28, 2025
Streamline your workflow: Submit BH authorizations through Availity EssentialsAnthem Blue Cross and Blue Shield | CommercialMarch 27, 2025
Specialty pharmacy updates — April 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 27, 2025
Outpatient preapproval update from Carelon Medical Benefits Management, Inc.Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 26, 2025
Prior authorization requirement changesEffective July 1, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 24, 2025
Carelon Medical Benefits Management, Inc. updatesEffective on May 1, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 19, 2025
Medicare Part B preapproval expands with new drug additionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 19, 2025
Technical difficulties: My Diverse PatientsAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 14, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 14, 2025
Controlling High Blood Pressure (CBP) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 11, 2025
Care for Older Adults (COA) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 11, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective April 12, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 6, 2025
Prior authorization requirement changesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 3, 2025
Important information about specialty prescriptionsEffective March 1, 2025
Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Clinical Criteria updates for specialty pharmacy are availableAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Coverage Guideline update — June 1, 2025Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 1, 2025
Reminder: provider data attestationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 1, 2025
Streamline your workflow with Care Central on Availity EssentialsAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Update: Drug claims edits to focus on FDA‑approved indicationsAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Precertification list change notification March 1, 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Changes in Postal Service Health Benefits for 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
New coding guidelines: include the anatomic modifierAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 28, 2025
Important change to your patients’ specialty prescriptionsEffective April 1, 2025
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 28, 2025
Resources to support diverse patients and communitiesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 28, 2025
Update: Availity launches enhanced provider enrollment features for improved efficiencyAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 27, 2025
Clinical Criteria updatesEffective March 28, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 26, 2025
Clinical Criteria updatesEffective March 28, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 25, 2025
Prior authorization updates for medications billed under the medical benefitEffective April 1, 2025
Orencia and Avsola
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 24, 2025
Prior authorization updates for medications billed under the medical benefitEffective April 1, 2025
Tevimbra and Tyenne
Anthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 21, 2025
Advanced Illness and Frailty Exclusions 2025HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 21, 2025
You are invited: provider office hours scheduled for CCC Plus Waiver Providers and Nursing FacilitiesAnthem Blue Cross and Blue Shield | CommercialFebruary 21, 2025
Start 2025 with an easy way to earn continuing education creditsAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 20, 2025
MCG Care Guidelines 29th editionEffective June 1, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 20, 2025
Doula and OB delivery claim denialsHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 19, 2025
Prior authorization updates for medications billed under the medical benefitEffective April 1, 2025
Anktiva, Hercessi, and Imdelltra
Anthem Blue Cross and Blue Shield | CommercialFebruary 18, 2025
MCG Care Guidelines 29th editionEffective June 1, 2025