CommercialPrior AuthMedium impact
Preauthorization Updates
EmblemHealth·NY·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated multiple preauthorization lists including GHI PPO City of New York, Home Infusion Therapy Drug lists, and Pharmacy Medical Preauthorization Lists for EmblemHealth and ConnectiCare plans. Billing teams need to review the updated lists to ensure proper prior authorization requirements are followed.
Action Required
Immediately: Billing team must access the EmblemHealth provider portal to review updated preauthorization lists for GHI PPO City of New York, Home Infusion Therapy Drug services, and Pharmacy Medical services. Update billing system rules and encounter forms to reflect new prior authorization requirements. Verify preauth requirements before submitting claims to avoid denials.