CommercialPrior AuthMedium impact
[Ohio] Expansion of specialty pharmacy precertification list
Anthem BCBS·OH·Pharmacy
We identified it
May 3, 2026
Summary
Anthem Ohio has expanded their list of specialty pharmacy medications requiring precertification. This means more specialty drugs will need prior authorization approval before they can be dispensed or prescribed.
Action Required
Immediately: Billing team must access the updated precertification list at the Anthem Ohio provider portal. Update prior authorization tracking systems to include newly added specialty pharmacy medications. Train staff to verify precertification requirements for all specialty drug prescriptions before claims submission. Claims for non-precertified specialty medications will be denied.