All PlansPrior AuthMedium impact
Pharmacy Preauthorizations
EmblemHealth·Pharmacy
Effective date
Dec 22, 2025
We identified it
Jun 20, 2026
Summary
Starting December 22, 2025, providers must contact Prime Therapeutics Medical Pharmacy Solutions for preauthorization of select specialty drugs under the medical benefit, effective January 1, 2026. This creates a new preauthorization pathway through gatewaypa.com or by calling 833-519-4548.
Action Required
By December 22, 2025: Billing team must update prior authorization procedures for specialty drugs under medical benefit. Add Prime Therapeutics contact information (gatewaypa.com or 833-519-4548) to preauthorization workflow. Update staff training on new preauth process effective January 1, 2026. Review full announcement for complete list of affected specialty drugs.