CommercialPrior AuthMedium impact
OfficeLink Updates - August 2024 notices and reminders (PDF)
Aetna·Oncology, Hematology, Rheumatology +2 more·Newsletter
Effective date
Aug 1, 2024
We identified it
Jun 23, 2026
Summary
Aetna is implementing new prior authorization requirements for four specialty drugs, with some taking effect August 1, 2024 and others November 1, 2024. The policy also includes reminders about existing coverage exclusions for disposable hearing aids and services with non-covered diagnoses.
Action Required
By July 18, 2024: Update billing system to require prior authorization for Anktiva and Beqvez (codes J3490, J3590, C9399, J9999) effective August 1. By October 18, 2024: Add prior auth requirements for Krystexxa (J2507) and site-of-care precertification for Vyvgart Hytrulo (J9334) effective November 1. Submit all precertification requests at least two weeks in advance through Availity portal or use Novologix for specialty drugs. Claims will be denied without proper precertification.