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