CommercialPrior AuthMedium impact
[New York] Anthem expands specialty pharmacy precertification list
Anthem BCBS·NY·Pharmacy
We identified it
May 3, 2026
Summary
Anthem has expanded their specialty pharmacy precertification list, requiring prior authorization for additional specialty medications. This affects billing for specialty drugs that previously did not require precertification.
Action Required
Immediately: Review the expanded precertification list on Anthem's provider portal. Update billing workflows to verify prior authorization status for all specialty pharmacy medications before dispensing or billing. Train staff to check precertification requirements for specialty drugs that may have been added to the list.