Anthem BCBSMedium ImpactPrior Auth
[Georgia] August 1 specialty pharmacy criteria updates — PA changes may limit coverage
Published May 28, 2026Effective August 1, 2024
AI Summary
Anthem Georgia updated specialty pharmacy criteria effective August 1, with prior authorization changes that may limit coverage for specialty medications. These updates could affect prescription drug coverage and require new PA requirements.
Action Required
Immediately: Billing team should review the full policy details at the Anthem Georgia provider portal to identify specific specialty medications affected by new PA requirements. Update prior authorization workflows for specialty pharmacy prescriptions. Verify PA requirements before prescribing or billing for specialty medications to avoid claim denials.
Plan Types
Commercial
States
GA
Specialties
all-specialties