[New York] Expansion of specialty pharmacy precertification list
AI Summary
Anthem New York has expanded their list of specialty pharmacy medications that require precertification before dispensing. This means more specialty drugs will now need prior authorization approval before patients can receive them, potentially affecting billing and patient care workflows.
Action Required
Immediately: Review the expanded precertification list on Anthem's provider portal to identify which specialty medications now require prior authorization. Update pharmacy benefit verification procedures to check precertification requirements for all specialty drugs before prescribing. Train clinical staff to initiate prior authorization requests earlier in the treatment process to avoid delays.
Plan Types
Commercial
States
NY
Specialties
oncology, rheumatology, neurology, gastroenterology, dermatology, endocrinology, nephrology