Medicare AdvantagePrior AuthMedium impact
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management (July 2026 Newsletter)
Anthem BCBS·VA·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Jun 17, 2026
Summary
Anthem Blue Cross and Blue Shield Virginia has updated precertification and prior authorization requirements managed by Carelon Medical Benefits Management, with specific changes to genetic testing coverage effective October 1, 2026. This policy specifically affects Medicare Advantage plans in Virginia.
Action Required
By October 1, 2026: Billing team must review and implement updated prior authorization requirements for genetic testing procedures under Carelon Medical Benefits Management. Access the full policy details at the provided URL to identify specific genetic testing services requiring precertification. Update billing workflows and staff training accordingly to ensure compliance with new authorization processes.