Anthem BCBSMedium ImpactPrior Auth
[New York] Anthem expands specialty pharmacy precertification list
Published May 3, 2026
AI 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: Billing team must access the updated precertification list at the Anthem provider portal to identify newly added specialty medications. Update prior authorization workflow to include these medications before prescribing or dispensing. Verify precertification requirements for all specialty pharmacy claims before submission to prevent denials.
Plan Types
Commercial
States
NY
Specialties
all-specialties