CommercialPrior AuthMedium impact
Preauthorization List Updates
EmblemHealth·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated multiple preauthorization lists including GHI PPO City of New York, ConnectiCare Commercial and Medicare plans, Home Infusion Therapy drugs, and Pharmacy Medical preauthorization requirements. The billing team needs to review the updated lists to identify services that now require or no longer require prior authorization.
Action Required
Immediately: Billing team must access the EmblemHealth provider portal to review updated preauthorization lists for GHI PPO City of New York, ConnectiCare Commercial, ConnectiCare Medicare, Home Infusion Therapy drugs, and Pharmacy Medical services. Update billing system rules and encounter forms to reflect new prior authorization requirements. Train staff on changes to avoid claim denials.