CommercialPrior AuthMedium impact
[Virginia] Anthem expands specialty pharmacy precertification list
Anthem BCBS·VA·Pharmacy
We identified it
May 3, 2026
Summary
Anthem has expanded their specialty pharmacy precertification list, adding new medications that now require prior authorization before dispensing. This affects billing for specialty pharmacy services and may impact claim approvals for affected medications.
Action Required
Immediately: Billing team should access the Anthem provider portal to review the updated specialty pharmacy precertification list. Update internal medication authorization tracking to include newly added medications. Coordinate with clinical staff to ensure prior authorizations are obtained before prescribing affected specialty medications to avoid claim denials.