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CommercialPrior AuthMedium impact

Pharmacy Preauthorization List Updates

EmblemHealth·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

ConnectiCare and EmblemHealth have updated their pharmacy preauthorization lists to include new medications requiring prior authorization. The billing team must review the revision histories to identify affected drugs, their effective dates, and required codes for proper claim submission.

Action Required

Action needed
Immediately: Billing team must access the ConnectiCare and EmblemHealth pharmacy preauthorization lists at the source URL to review revision histories. Identify newly added medications requiring prior auth, note their effective dates, and update billing system with required codes. Notify providers of new PA requirements to prevent claim denials.

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