CommercialPrior AuthMedium impact
Preauthorization List Updates
EmblemHealth·NY·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have updated multiple preauthorization lists including GHI PPO City of New York, home infusion therapy drugs, and pharmacy medical services. Billing teams need to review the updated lists to ensure proper prior authorization is obtained for affected services to avoid claim denials.
Action Required
Immediately: Billing team must access the updated preauthorization lists at the EmblemHealth provider portal to review changes to GHI PPO City of New York services, home infusion therapy drugs, and pharmacy medical services. Update prior authorization workflow and staff training materials to reflect new requirements. Verify prior auth requirements before submitting claims to avoid denials.