Anthem BCBSMedium ImpactPrior Auth
[Ohio] Expansion of the specialty pharmacy precertification list
Published May 3, 2026
AI Summary
Anthem Ohio has expanded their specialty pharmacy precertification list, meaning more specialty medications now require prior authorization before they can be dispensed. This affects billing for specialty drugs that previously did not need pre-approval.
Action Required
Immediately: Billing team should access the updated precertification list at the provided URL to identify which specialty medications now require prior authorization. Update billing workflows to verify prior auth status before dispensing newly added specialty drugs. Train staff to check precertification requirements for all specialty pharmacy medications to avoid claim denials.
Plan Types
Commercial
States
OH
Specialties
all-specialties