Medicare AdvantagePrior AuthMedium impact
Upcoming Enhancements to the Electronic Prior Authorization for Drugs
CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is upgrading its electronic prior authorization system for drugs, starting with Medicare Advantage members on January 1, 2021. The new system features improved dashboards and streamlined workflow through the Provider Portal, with full rollout to all members by mid-2021.
Action Required
By January 1, 2021: Billing and clinical staff must transition to the new PA notification system in CareFirst Direct Provider Portal. Click 'Start Now' in the 'Pharmacy (All lines of business)' section for drug PAs instead of using the Medical (Commercial/FEP) section, which will be retired by mid-2021. Review the 'Instructions' section to learn the streamlined process.