CommercialDocumentationMedium impact

[New York] Genetic testing claims for FEP members: medical records required for review

Q: Who is affected by this change?

This affects Anthem BCBS Family Medicine, Internal Medicine, Oncology, OB-GYN, Cardiology, Neurology providers in NY on Commercial plans.

Anthem BCBS·NY · Family Medicine, Internal Medicine, Oncology +3 more·Provider Bulletin

Effective date

Not stated

We identified it

May 29, 2026

Days to comply

—

Summary

FEP (Federal Employee Program) members now require medical records to be submitted for genetic testing claim reviews. This affects all genetic testing claims for federal employees and requires additional documentation beyond standard claims submission.

Action Required

Action needed

Immediately: Billing team must update procedures to include medical records submission for all genetic testing claims for FEP members. Coordinate with providers to ensure complete medical documentation is available before submitting genetic testing claims. Add FEP flag to billing system to trigger medical records requirement for genetic testing procedures.

Related policy hubs

Anthem BCBS policies NY policy changes Family Medicine Internal Medicine Oncology OB-GYN Cardiology Neurology