Anthem BCBSMedium ImpactPrior Auth
[Ohio] Anthem expands specialty pharmacy precertification list
Published May 3, 2026
AI Summary
Anthem has expanded their specialty pharmacy precertification list, requiring additional prior authorizations for certain specialty medications. This affects billing teams who need to ensure proper prior authorization is obtained before dispensing these medications to avoid claim denials.
Action Required
Immediately: Review the updated specialty pharmacy precertification list on Anthem's provider portal. Update billing workflows to flag specialty medications requiring prior authorization. Train staff to verify precertification status before medication administration or prescription fulfillment. Claims for non-precertified specialty medications will be denied.
Plan Types
Commercial
States
OH
Specialties
all-specialties