CommercialPrior AuthHigh impact
[Ohio] Prior authorization and step therapy updates for medications billed under the medical benefit
Anthem BCBS·OH·Provider Bulletin
We identified it
Jun 13, 2026
Summary
Anthem Ohio has updated prior authorization and step therapy requirements for medications billed under the medical benefit. This affects medical billing for physician-administered drugs and injectables that require prior approval before administration.
Action Required
Immediately: Billing team must access the full policy details at the Anthem provider portal to identify specific medications affected by new prior authorization requirements. Update billing workflows to verify prior authorization status for medical benefit drugs before administration. Train staff on new step therapy protocols that may require trying alternative medications first.