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| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Aceclidine | 2025-11-01 |
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| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Adefovir | 2025-11-01 |
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| Ambetter Health Iowa Clinical | Skin and Soft Tissue Substitutes for Diabetic Foot Ulcers and Venous Leg Ulcers | 2025-11-01 |
| Sunshine Health Clinical Policy | Proton and Neutron Beam Therapies | 2025-11-01 |