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[New York] Updates to Carelon Medical Benefits Management Clinical Appropriateness Guidelines effective
Anthem BCBS·NY·Provider Bulletin
We identified it
Jun 13, 2026
Summary
Carelon Medical Benefits Management has updated their Clinical Appropriateness Guidelines effective recently. This update affects prior authorization requirements and clinical criteria for medical services managed by Carelon (formerly AIM Specialty Health).
Action Required
Immediately: Review the updated Carelon Medical Benefits Management Clinical Appropriateness Guidelines at the source URL. Identify any changes to prior authorization requirements or clinical criteria that may affect your practice's services. Update internal processes and staff training as needed based on the specific guideline changes.