Prior authorization requirements update for MMP: effective January 1, 2016
Effective January 1, 2016, there will be new prior authorization requirements for members enrolled in Anthem HealthKeepers Medicare-Medicaid Plan (MMP), a Commonwealth Coordinated plan. Precertification requirements will be required for vascular angioplasty/stent and knee and hip replacements.
Addition to Part B injectibles/infusibles for MMP: effective January 1, 2016
Anthem HealthKeepers Medicare-Medicaid Plan (MMP), a Commonwealth Coordinated Care plan is adding Praluent, Repatha and Sylvant to its 2016 list of Part B injectables/infusibles. As of January, 1 2016, providers must call for prior authorization of these drugs.
Hemophilia drugs authorization update effective November 15, 2015
Effective November 15, 2015, certain hemophilia drug requests must be reviewed by HealthKeepers, Inc. for prior authorization for Anthem HealthKeepers Plus members.
October Edition of Network Update is now available
This edition contains news, announcements and information for Medicaid and MMP providers.
October 2015 Network Update