CommercialPrior AuthMedium impact
Medical Drug Prior Authorization Updates
CareFirst BlueCross BlueShield·MD·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield Community Health Plan Maryland is adding new medications to their prior authorization requirements effective July 1, 2025. The billing team must review the updated Medical Drug Prior Authorization List to identify which drugs now require prior approval before administration or prescription.
Action Required
Before July 1, 2025: Billing team must access and review the updated Medical Drug Prior Authorization List on the CareFirst CHPMD provider website. Update billing system and encounter forms to flag newly added medications requiring prior authorization. Notify providers of new prior auth requirements to prevent claim denials.