Anthem BCBSMedium ImpactPrior Auth
[New York] Anthem expands specialty pharmacy precertification list
Published June 2, 2026
AI Summary
Anthem has expanded their list of specialty pharmacy medications that require precertification before dispensing. This affects billing for specialty drugs and may result in claim denials if prior authorization is not obtained for newly added medications.
Action Required
Immediately: Review the expanded precertification list on Anthem's provider portal to identify newly added specialty medications. Update billing workflows to verify precertification status before dispensing or prescribing these medications. Train staff to check authorization requirements for all specialty pharmacy drugs to prevent claim denials.
Plan Types
Commercial
States
NY
Specialties
oncology, rheumatology, neurology, gastroenterology, dermatology, endocrinology