All PlansCoverageMedium impact
Medical Specialty Drug Policies G H
HMSA·Oncology, Rheumatology, Endocrinology +4 more·Pharmacy
We identified it
Jun 20, 2026
Summary
HMSA has updated their Medical Specialty Drug Policies for drugs beginning with letters G and H. This is a summary-only update that likely affects coverage criteria, prior authorization requirements, or billing procedures for specialty medications in these letter categories.
Action Required
Immediately: Billing team and providers should review the updated HMSA Medical Specialty Drug Policies G-H at https://prc.hmsa.com/s/article/Medical-Specialty-Drug-Policies-G-H to identify any changes to prior authorization requirements, coverage criteria, or billing procedures for specialty drugs beginning with G or H. Update prior authorization workflows and documentation requirements as needed based on policy changes.