By July 23, 2026: (1) Billing and clinical teams must access Anthem's Clinical Criteria page (https://providernews.anthem.com/new-york/articles/clinical-criteria-updates-30731) and review the specific updates for all 26 revised/new criteria (CC-0003, CC-0011, CC-0027, CC-0029, CC-0058, CC-0065, CC-0068, CC-0072, CC-0104, CC-0124, CC-0127, CC-0128, CC-0142, CC-0149, CC-0159, CC-0174, CC-0182, CC-0213, CC-0222, CC-0227, CC-0229, CC-0235, CC-0236, CC-0263, CC-0300, CC-0301). (2) Update all clinical documentation templates, encounter forms, and prior authorization submission procedures to reflect new medical necessity requirements for affected specialty drugs. (3) Notify all providers and clinical staff of changes and distribute the policy summary. (4) Verify billing system workflows align with any new authorization requirements (communicated separately by Anthem). (5) Train staff that these criteria apply ONLY to medical drug benefits, not pharmacy services. NOTE: This policy applies to New York Medicare Advantage members only; separate authorization requirement notices are expected from Anthem.