Anthem BCBSMedium ImpactPrior Auth
[Virginia] Expansion of specialty pharmacy precertification list
Published May 3, 2026
AI Summary
Anthem Virginia has expanded their specialty pharmacy precertification list, requiring prior authorization for additional specialty medications. This affects billing for specialty drug claims that previously did not require precertification.
Action Required
Immediately: Billing team must review the expanded specialty pharmacy precertification list on Anthem's Virginia provider portal. Update billing system to flag new specialty medications requiring prior authorization. Verify precertification status before dispensing or billing for specialty pharmacy claims to prevent denials.
Plan Types
Commercial
States
VA
Specialties
all-specialties