Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 2019

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.

 

Medical Policies and Clinical Guidelines

 

• Clinical Guidelines Updates – May 2019*

 

• Anthem MCG Care Guidelines – 23rd Edition*

 

Reimbursement Policies

 

• Update: Drug Screen Testing – Professional*

 

Pharmacy Updates

 

• Anthem expands specialty pharmacy medical step therapy drug list for agents for hereditary angioedema

 

• Anthem specialty pharmacy medical step therapy drug list clarification about non oncology colony stimulating factor agents

 

Other Important Updates

 

• Medicare and Medicaid News