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CommercialPrior AuthMedium impact

[Virginia] Expansion of specialty pharmacy precertification list

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

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

Action needed
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.

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