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All PlansCoverageMedium impact

Medical Policies Medical Pharmacy

HMSA·HI·Pharmacy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

HMSA has updated their Medical Pharmacy policies affecting prescription drug coverage and billing procedures. The policy is extremely recent (1 day old) and requires immediate review of pharmacy-related billing practices.

Action Required

Action needed
Immediately: Billing team must review the updated HMSA Medical Pharmacy policies at https://prc.hmsa.com/s/article/Medical-Policies-Medical-Pharmacy to identify specific changes to drug coverage, prior authorization requirements, and billing procedures. Update billing system settings and provider encounter forms based on new pharmacy policy requirements.

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