Anthem BCBSHigh ImpactPrior Auth

[California] Prior authorization and step therapy updates for medications billed under the medical benefit

Published May 3, 2026

AI Summary

Anthem Blue Cross in California has updated prior authorization and step therapy requirements for medications billed under the medical benefit. This affects medication billing workflows and may require new authorizations for certain drugs previously covered without prior approval.

Action Required

Immediately: Billing team must access the full policy details at the provided URL to identify specific medications affected by new prior authorization requirements. Update billing system alerts for medical benefit drug claims. Verify authorization status before submitting claims for medications under medical benefit to prevent denials.

Plan Types

Commercial

States

CA

Specialties

all-specialties