Anthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 8, 2024
Anthem expands specialty pharmacy precertification list
RETRACTION: This article, originally published on January 8, 2024, was retracted on February 5, 2024. Beyfortus is not covered under Medicare Part B and therefore, not included in the precertification review process.
Effective for dates of service on and after May 1, 2024, the specialty Medicare Part B drug listed in the table below will be included in our precertification review process.
Federal and state law, as well as state contract language and CMS guidelines (including definitions and specific contract provisions/exclusions), take precedence over these precertification rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.
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Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc. Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc., serving all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123, are independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
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