CommercialPrior AuthHigh impact
Preauthorization Updates
EmblemHealth·NY·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated multiple preauthorization lists affecting GHI PPO City of New York, ConnectiCare and EmblemHealth home infusion therapy drugs, and pharmacy medical preauthorization requirements. The billing team must review the updated lists to identify which services now require prior authorization.
Action Required
Immediately: Billing team must access the updated preauthorization lists at EmblemHealth's provider portal to identify newly added services requiring prior authorization. Update billing system rules for GHI PPO City of New York plans, ConnectiCare home infusion therapy drugs, EmblemHealth home infusion therapy drugs, and pharmacy medical services. Train staff on new prior auth requirements to prevent claim denials.