Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 2021

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.*

• Updates for specialty pharmacy are available – May 2021*
• New prior authorization requirement: Kidney transplantation*
• Updated AIM rehabilitative program effective August 1, 2021 – Initial evaluations and site of service reviews*
• Reimbursement policy update: Claims requiring additional documentation – Facility*