CommercialPrior AuthMedium impact
Medications Added to Prior Authorization List—Effective January 1, 2024
CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Effective January 1, 2024, CareFirst is adding certain medications to their prior authorization list and implementing site of care management for specialty drugs to control rising costs. The preferencing strategy for select medical benefit medications will also be updated.
Action Required
By December 31, 2023: Billing team must review the full medication list on CareFirst provider portal to identify which specialty drugs now require prior authorization. Update billing system workflows to flag these medications for prior auth verification before prescribing or administering. Notify providers of new requirements to prevent claim denials starting January 1, 2024.