Anthem BCBSHigh ImpactPrior Auth
[Virginia] Prior authorization and step therapy updates for medications billed under the medical benefit
Published May 21, 2026
AI Summary
Anthem Virginia has updated prior authorization and step therapy requirements for medications billed under the medical benefit. This affects medications administered in healthcare facilities rather than dispensed at pharmacies.
Action Required
Immediately: Billing team must review the full policy details at the source URL to identify specific medications now requiring prior authorization. Update billing system alerts for affected drug codes. Verify prior authorization status before administering medications billed under medical benefit to avoid claim denials.
Plan Types
Commercial
States
VA
Specialties
all-specialties