CommercialPrior AuthMedium impact
Pharmacy Preauthorization List Updates
EmblemHealth·Prior Authorization
We identified it
Jun 20, 2026
Summary
ConnectiCare and EmblemHealth have restructured their preauthorization lists, separating medical and pharmacy benefits into distinct documents. Both pharmacy preauthorization lists have been reformatted and updated with July 1, 2022 CMS code changes.
Action Required
Immediately: Billing and prior authorization staff must download and review the updated separate preauthorization lists for medical and pharmacy benefits from ConnectiCare and EmblemHealth. Replace old combined lists with new format documents. Update internal prior authorization workflows to reference correct list based on whether service is covered under medical or pharmacy benefits.