Medicare AdvantagePrior AuthMedium impact
[California] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management (July 2026 Newsletter)
Anthem BCBS·CA·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Jun 17, 2026
Summary
Anthem Blue Cross California has released prior authorization requirement updates through Carelon Medical Benefits Management, with specific changes to genetic testing prior auth requirements effective October 1, 2026 for Medicare Advantage plans.
Action Required
By October 1, 2026: Billing team must review and implement updated prior authorization requirements for genetic testing services for Medicare Advantage patients. Contact Carelon Medical Benefits Management for specific authorization procedures. Update billing workflows to ensure compliance with new genetic testing prior auth requirements to avoid claim denials.