By September 15, 2026: Billing team must (1) access www.gatewaypa.com/policydisplay/52 and www.myprime.com/en/forms.html to retrieve detailed clinical criteria and quantity limit requirements for all updated pharmacy programs; (2) update billing software to require prior authorization for 10 new medical drugs effective Oct 1 (Evdi, Filkri, Immgolis Intri, Lumvoa, Otarmeni, Revtorpyk, Sarclisa Escena, Tregzi, Wainua PFS, Waskyra); (3) configure new retail pharmacy UM program edits for Leqembi, IQ, LIKI, NetResults, Vascepa, and Voyxact; (4) retire the Antidepressant ST program and remove it from all prior authorization workflows; (5) update quantity limit edits for oral anticoagulants (Xarelto starter pack to 51 tabs/180 days; Xarelto 15mg to 42 tablets per 30 days), Long-Acting Insulin (add Civica insulin glargine-yfgn), and all updated programs listed; (6) update formulary status reflecting removal of Humira Pediatric Crohn's starter kits, Kombiglyze XR, Nesina, Renagel brand, Ditropan XL brand, Roszet, and addition of new preferred products (Avtozma, Zolymbus, Lerochol, Saphnelo prefilled formulations, Atonce, Bysanti); (7) configure approval length changes (Bonjesta/Diclegis to 6 months; Dry Eye Disease targets except Eysuvis to 12 months); and (8) train billing and clinical staff on all new clinical criteria updates for programs including GLP-1 Agonists, Multiple Sclerosis, CGRP, IL-4/IL-5/IL-13/IL-31, Self-Administered Oncology, SGLT2 Inhibitors, and others. Failure to implement these changes will result in claim denials for non-compliant prior authorizations and billing errors for quantity limit violations.