By July 15, 2026: Billing team must update billing software and prior authorization workflows to reflect new Anthem specialty pharmacy requirements for New York commercial plans. (1) Add the following drugs to prior auth requirement matrix: Bonscresa, Lerochol, Nufymco, Oziltus, Rybrevant Faspro, Yartemlea, and Zycubo with associated HCPCS codes (C9399, J3590, J3490, J9999). (2) Configure quantity limits for Bonscresa, Lerochol, Nufymco, Oziltus, and Zycubo. (3) Mark Bonscresa, Lerochol, Nufymco, and Oziltus as non-preferred for step therapy review. (4) Set site of care requirements for testosterone cypionate, denosumab biosimilars, leuprolide, emapalumab, nipocalimab, epoetin beta, fosdenopterin, zopapogene, fitusiran, and lanreotide. (5) Notify providers to expect prior auth requests starting August 1, 2026 for patients currently on these medications. (6) Verify Carelon Medical Benefits Management processes for oncology use medications (marked with *). Failure to implement these controls will result in claim denials for affected specialty pharmacy medications.