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.

  • Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual*
  • Designated Specialty Pharmacy Network*
  • Updates for specialty pharmacy are available*
  • Medical policy and clinical guideline updates*
  • Update: Clinical guideline adoption postponed*
  • MCG Care Guidelines 25th Edition available*
  • Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNF) facilities
  • Maximizing efficient, high quality COVID-19 screenings*
  • New reimbursement policy: Newborn Inpatient Stays for facilities*

Featured In:
April 2021 Anthem Provider News - Wisconsin