Anthem BCBSMedium ImpactCoverage
[New York] Clinical Criteria updates for specialty pharmacy
Published May 3, 2026
AI Summary
Anthem updated clinical criteria for specialty pharmacy medications in New York. The billing team should review current specialty drug authorization processes to ensure compliance with new coverage requirements.
Action Required
Immediately: Review the updated clinical criteria at the provided URL to identify changes to specialty pharmacy coverage requirements. Update prior authorization workflows for affected specialty medications. Verify current specialty drug claims align with new criteria before submission.
Plan Types
Commercial
States
NY
Specialties
all-specialties