To view the current version of this medical policy, please click the link below:
To view previous versions of this policy that are now expired, please click on the links below:
|Rev#:||Date:||Nature of Change:|
|1.0||12/31/2014||Replaced the 90-day notice version with the clean version of this policy.|
|1.1||12/31/2014||Created a link to the new 90-day notice version of the policy.|
|1.2||08/24/2015||Created a link to the new 90-day notice version of the policy.|
|1.4||12/19/2016||Created a link to the new 90-day notice version of the policy, effective 5/1/17.|
|1.5||06/26/2017||Added a link to the clean, current policy (which replaced the 90-day notice) and moved the expired policy into the “previous” section. The 90-day notice policy was removed.|
|1.6||12/28/2017||Added a link to the new 90-day notice version of this policy, effective 05/01/2018.|
|1.7||05/07/2018||Added a link to the new, clean version of this policy, effective 05/01/2018.|
|1.8||08/31/2018||Added a new link to the current policy (effective 08/29/2018) and moved the expired policy into the “previous” section.|
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