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CommercialPrior AuthMedium impact

Preauthorization List Updates

EmblemHealth·Oncology, Infectious Disease, Gastroenterology +2 more·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth and ConnectiCare have added a new Home Infusion Therapy Drug Preauthorization List effective January 1, 2023, which defines specific drugs requiring preauthorization for home infusion services. Multiple preauthorization lists have been updated with changes documented in revision histories.

Action Required

Action needed
Immediately: Billing team must review the new Home Infusion Therapy Drug Preauthorization List on EmblemHealth and ConnectiCare websites to identify which home infusion drugs now require preauthorization. Update billing system to flag these drugs for prior auth verification before claims submission. Check revision histories for EmblemHealth, GHI PPO City of New York, and ConnectiCare preauthorization lists for any additional changes. Claims for listed drugs without prior authorization will be denied.