CommercialPrior AuthMedium impact
Upcoming CareFirst Formulary Updates Effective January 1, 2022
CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is making quarterly formulary updates effective January 1, 2022, which may include drug additions, tier changes, utilization management changes, and medication removals. These changes affect patients with CareFirst prescription benefits and may impact prior authorization requirements for medications.
Action Required
Before January 1, 2022: Clinical and billing staff should review the CareFirst formulary update summary available on their provider portal to identify specific medication changes. Update prior authorization workflows for any medications with new utilization management requirements. Inform providers of tier changes that may affect patient costs and prescribing decisions.