Key Updates
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 1, 2025
Reminder: provider data attestation
Recent Updates
Anthem Blue Cross and Blue Shield | CommercialMay 22, 2025
Action required: annual patient safety attestationAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 21, 2025
2025 Clinical Practice GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 21, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective June 25, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 20, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Ahzantive, Enzeevu, Opuviz, Pavblu, and Yesafili
Anthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 20, 2025
Automated renewals for respite authorizationsHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 15, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Boruzu, Nemluvio, Rytelo, Selarsdi, and Tecelra
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 14, 2025
Carelon Medical Benefits Management, Inc. updatesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 13, 2025
Clinical Criteria updatesEffective June 20, 2025
Anthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Coverage and Clinical Guidelines update August 1, 2025Anthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Wellness visits may increase appointment scheduling For members enrolled in an ACA planAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Free CE training: Lifestyle Medicine & Food as Medicine Essentials CourseAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Streamline your prior authorizations with our digital toolsAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2025
Additional drug codes added to medical claims edit systemHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2025
FDA lifts risk evaluation and mitigation strategy reporting requirements for ClozapineAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Clinical Criteria updates for specialty pharmacy are availableEffective August 1, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2025
Enhancing your learning experience: latest updates in Provider PathwaysAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 30, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective August 1, 2025
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 29, 2025
New preapproval rules for medicationsEffective June 1, 2025
Ebglyss, Lymphir, Niktimvo, and Ocrevus Zunovoa
HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 29, 2025
Important guidelines for avoiding common billing errors in DME claimsHealthKeepers, 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 | 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
Codes: J9248 and L5841
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
HealthKeepers, 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 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
New coding guidelines: include the anatomic modifierHealthKeepers, 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
Changes in Postal Service Health Benefits for 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Precertification list change notification March 1, 2025Anthem 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
Clinical Criteria updates for specialty pharmacy are availableAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Coverage Guideline update — June 1, 2025