Anthem BCBSHigh ImpactPrior Auth

[New York] Prior authorization and step therapy updates for medications billed under the medical benefit

Published May 14, 2026

AI Summary

Anthem has updated prior authorization and step therapy requirements for medications billed under the medical benefit in New York. This affects medications administered in clinical settings that require medical billing rather than pharmacy dispensing.

Action Required

Immediately: Access the full policy details at the provided URL to identify specific medications and prior authorization requirements. Update billing workflows to verify prior authorization status before administering affected medications. Train staff on new step therapy protocols that may require trying alternative medications first.

Plan Types

Commercial

States

NY

Specialties

all-specialties