What insurance policy changes affect Infectious Disease providers?

Infectious Disease providers face policy updates from major payers including prior authorization requirements, billing code changes, reimbursement rate adjustments, and coverage criteria revisions. PolicyChanges.app tracks these updates daily across all major insurers.

How often do insurance policies change for Infectious Disease?

Insurance payers publish policy changes on rolling schedules: some quarterly, some monthly, and some with immediate effect. Infectious Disease practices typically see dozens of relevant changes per year across their contracted payers.

How do I get notified of new Infectious Disease policy changes?

Sign up for a free PolicyChanges.app account and create a saved search filtered to Infectious Disease. You will receive a daily digest whenever a new policy change matches your specialty filter.

Which payers post the most policy changes affecting Infectious Disease?

Based on tracked changes, Infectious Disease updates have come from payers including Blue Cross Blue Shield of Kansas, Capital Blue Cross, Harvard Pilgrim Health Care, Anthem BCBS, BCBS Illinois.

Infectious Disease Insurance Policy Changes

Keeping up with insurance policy changes that affect Infectious Disease practices is a full-time job. This page aggregates the latest payer updates (prior authorization rule changes, reimbursement adjustments, billing code additions and removals, and coverage policy revisions) across all major insurers. Changes are identified and summarized daily so Infectious Disease providers and their billing teams can act before deadlines pass.

High impact

[Virginia] Specialty pharmacy updates — July 2026

Anthem BCBS·Effective Oct 1, 2026

Anthem Blue Cross and Blue Shield (Virginia) is implementing new prior authorization requirements, quantity limits, and updated clinical criteria for specialty pharmacy drugs effective October 1, 2026. Four drugs now require prior authorization (Fesilty, Loargys, Vykoura, and Leucovorin calcium), two drugs are subject to quantity limits (Loargys and Yuviwel), and eight clinical criteria documents have been updated that may result in previously covered services being denied as not medically necessary. Billing teams must begin requesting prior authorizations for affected specialty pharmacy claims and ensure NDC codes are included on claims using NOC billing codes.

Pharmacy Medical Policy Updates

AB2026-08-005 Medical policies

Laboratory Payment Policies: Sept. 1, 2026 updates

[Ohio] Precertification/prior authorization requirement changes

Pharmacy Program Updates: Prior Authorization Changes Effective Sept. 15, 2026

26-829sum Summary Update: 2nd Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk

[Ohio] Clinical Criteria updates

Changes to Preferred Biosimilar Medications Effective October 1, 2026

Pharmacy Policies Available Online

BT2026127: Pharmacy updates approved by Drug Utilization Review Board July 2026

COVID-19 Laboratory Tests Reimbursement Changes for Urgent Care Centers and Convenience Care Clinics

[California] Clinical Criteria updates

[California] Clinical Criteria updates

[New York] Specialty pharmacy updates — July 2026

[Virginia] Specialty pharmacy updates — July 2026

Positron Emission Tomography (PET) - Non-Oncologic Applications - (Effective Date - 2026-10-15) 6.01.07

Policy Criteria Change-Material Amendment

Enhanced Prepay Review of Commercial Sepsis Claims to Begin

Reimbursement Policy Updates

[Ohio] Clinical Criteria updates

Siltuximab (Sylvant™)

COVID-19 testing—Molecular and antigen updates eff. 10/1/2026

[New York] Expansion of Specialty Pharmacy precertification list

Mutual News August 2026 Newsletter

[California] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Ohio] Precertification/prior authorization requirement changes

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Georgia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Georgia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[New York] Precertification/prior authorization list change notification

[Ohio] Precertification/prior authorization list change notification

Medical Policy Updates August 5, 2026

Healthfirst Lab Reimbursement Policy Updates

AB2026-07-005 Medical policies

[New York] Clinical Criteria updates

[Virginia] Clinical Criteria updates

Medical and Clinical Policy Updates - Effective August 1, 2026

Medica Provider News: May 2026

[Georgia] Clinical Criteria updates

[New York] Clinical Criteria updates

[Virginia] Clinical Criteria updates

[Georgia] Clinical Criteria updates

KMAP BULLETIN: Pharmaceutical Prior Authorization Updates – May 2026

New Claims Editing Rules To Be Implemented in July 2026

New Claims Editing Rules To Be Implemented in July 2026