CommercialPrior AuthMedium impact
New Medications Requiring Approval and Site of Care Management - Effective January 1, 2026
CareFirst BlueCross BlueShield·Provider News
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, CareFirst BlueCross BlueShield will require prior authorization approval and site of care management for additional medications for commercial insurance members. The policy does not specify which medications are affected, requiring providers to review the full policy details.
Action Required
Before January 1, 2026: Billing and clinical teams must access the full policy article at the provided URL to identify specific medications requiring prior authorization. Update prior authorization workflows and EMR alerts for affected medications. Train staff on new site of care management requirements for commercial CareFirst members to avoid claim denials.