CommercialAdministrativeMedium impact
[Virginia] Unlock updated pharmacy insights today — visit our provider website
Anthem BCBS·VA·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
Anthem Blue Cross and Blue Shield (Virginia) is reminding providers to review updated pharmacy information on their provider website. Commercial and exchange drug lists are posted quarterly (January, April, July, October), with the next update on July 1, 2026. Providers must stay current on copay requirements, drug lists, prior authorization requirements, step therapy, and generic substitution procedures to ensure members receive optimal pharmacy benefits.
Action Required
By July 1, 2026: Billing and clinical staff must review updated pharmacy information on https://anthem.com/provider and https://www.anthem.com/pharmacy-information, including: (1) copay/coinsurance requirements by drug class; (2) updated drug lists and formulary changes; (3) prior authorization requirements; (4) generic substitution and therapeutic interchange procedures; (5) step therapy and other management methods. Billing team should update internal documentation of Anthem Virginia pharmacy requirements in billing system and staff training materials. Front desk and clinical staff should be informed of any changes to prior authorization procedures. Failure to follow updated requirements may result in claim denials or delayed member access to medications. For FEP plans, reference fepblue.org/pharmacy. For preapproval or exception requests, use carelonrx.com/solutions/providers.