Medicare AdvantageAdministrativeMedium impact
[New York] Faster access to medications starts with informed prescribing
Anthem BCBS·NY·Provider Bulletin
We identified it
Sep 2, 2026
Summary
Anthem Blue Cross and Blue Shield Medicare Advantage is promoting the use of Real-Time Prescription Benefit (RTPB) and electronic Prior Authorization (ePA) tools to expedite medication access and reduce prescription delays. This is an informational bulletin encouraging providers to leverage existing pharmacy applications in their EHR workflows to improve prescription decision-making and patient outcomes.
Action Required
Billing team and providers should: (1) Coordinate with EHR administrator to verify RTPB cost and coverage detail availability in the current prescribing workflow; (2) Confirm ePA capabilities are enabled and being utilized for medication prior authorization submissions; (3) Assess whether practice would benefit from additional training on RTPB and ePA features to reduce pharmacy delays and manual authorization work; (4) Educate prescribers that RTPB can identify lower-cost alternatives (average $77 savings per prescription, $817 for specialty) and ePA can expedite approvals up to 3x faster than phone/fax methods. No system changes or compliance deadlines are mandated by this bulletin.