By November 15, 2026: Billing team and providers must review the 27 updated clinical criteria policies (CC-0029, CC-0031, CC-0032, CC-0043, CC-0057, CC-0061, CC-0077, CC-0099, CC-0112, CC-0119, CC-0121, CC-0125, CC-0128, CC-0130, CC-0151, CC-0158, CC-0163, CC-0218, CC-0237, CC-0243, CC-0258, CC-0276, CC-0279, CC-0281, CC-0303, CC-0304, CC-0305, CC-0306) on Anthem's Clinical Criteria page to identify specific changes to medical necessity requirements. Contact Anthem immediately via the provided email to obtain detailed authorization requirements for each revised and new criterion. Update billing software, prior authorization templates, and clinical documentation requirements to reflect the new criteria. Failure to comply with updated medical necessity requirements will result in claim denials for affected specialty medications, particularly for oncology immunotherapies, biologic agents, and rare disease treatments.