Medicare AdvantagePrior AuthMedium impact
[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management (July 2026 Newsletter)
Anthem BCBS·NY·Provider Bulletin
Effective date
Aug 1, 2026
We identified it
Jun 17, 2026
Summary
Anthem Blue Cross and Blue Shield has updated prior authorization requirements for genetic testing services through Carelon Medical Benefits Management. The changes affect Medicaid plans starting August 1, 2026 and Medicare Advantage plans starting October 1, 2026.
Action Required
By August 1, 2026: Billing team must review and implement updated prior authorization requirements for genetic testing services for Medicaid patients. By October 1, 2026: Apply the same updated requirements for Medicare Advantage patients. Visit the provided URL https://providernews.anthem.com/new-york/articles/precertificationprior-authorization-requirement-updates-care-30471 for complete details on specific authorization requirements.