CommercialPrior AuthMedium impact
Preauthorization Updates
EmblemHealth·NY·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have updated their preauthorization lists for GHI PPO City of New York services, home infusion therapy drugs, and pharmacy medical services. Billing teams need to review the revised preauthorization requirements to ensure proper prior authorization is obtained for affected services and medications.
Action Required
Immediately: Billing team must review the updated preauthorization lists at the EmblemHealth provider portal for GHI PPO City of New York services, EmblemHealth/ConnectiCare home infusion therapy drugs, and pharmacy medical services. Update billing system rules and prior authorization workflows to reflect the revised requirements. Train staff on new preauthorization requirements to prevent claim denials.