CommercialPrior AuthHigh impact
Preauthorization Updates
EmblemHealth·NY·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth updated preauthorization requirements for GHI PPO City of New York plans and pharmacy medical preauthorization lists for EmblemHealth and ConnectiCare. Billing teams need to review the revised lists to ensure proper prior authorization is obtained before services are rendered.
Action Required
Immediately: Billing team must access the updated preauthorization lists at https://www.emblemhealth.com/providers/news/preauthorization-updates-202507 and review changes to GHI PPO City of New York requirements and pharmacy medical preauthorization for EmblemHealth and ConnectiCare plans. Update prior authorization workflows and staff training accordingly. Verify authorization requirements before scheduling services to prevent claim denials.