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CommercialPrior AuthMedium impact

[Virginia] Expansion of the specialty pharmacy precertification list

Anthem BCBS·VA·Pharmacy
Effective date
Not stated
We identified it
May 3, 2026
Days to comply

Summary

Virginia Anthem has expanded their specialty pharmacy precertification list, requiring prior authorization for additional specialty medications. This affects billing for specialty drugs that previously did not require precertification.

Action Required

Action needed
Immediately: Billing team must access the updated specialty pharmacy precertification list at the provided URL to identify newly added medications requiring prior authorization. Update billing system alerts for affected specialty drugs. Notify providers to obtain precertification before prescribing newly listed specialty medications to avoid claim denials.