By July 15, 2026: Billing team and clinical staff must access HealthKeepers' Clinical Criteria page and download the full policy text for each of the 47 revised/new criteria (CC-0002 through CC-0299). For each affected drug in your formulary, review the updated medical necessity requirements. Update prior authorization workflows, EMR templates, and billing system rules to reflect new clinical criteria edits. Communicate changes to providers prescribing biologics, immunotherapies, and cancer treatments. Establish internal audit process to verify claims for affected medications include supporting documentation per new criteria. Failure to implement updated criteria may result in claim denials for CC-0002, CC-0027, CC-0033, CC-0034, CC-0042, CC-0043, CC-0050, CC-0062, CC-0063, CC-0064, CC-0066, CC-0067, CC-0071, CC-0072, CC-0078, CC-0088, CC-0089, CC-0090, CC-0094, CC-0096, CC-0099, CC-0107, CC-0108, CC-0109, CC-0110, CC-0112, CC-0115, CC-0118, CC-0119, CC-0121, CC-0123, CC-0124, CC-0125, CC-0126, CC-0128, CC-0129, CC-0131, CC-0132, CC-0135, CC-0137, CC-0157, CC-0158, CC-0166, CC-0170, CC-0186, CC-0201, CC-0211, CC-0221, CC-0232, CC-0253, CC-0261, CC-0273, CC-0278, CC-0279, CC-0280, CC-0281, CC-0296, CC-0297, CC-0298, and CC-0299.