CommercialPrior AuthMedium impact

[California] Expansion of Specialty Pharmacy Precertification List

Q: Who is affected by this change?

This affects Anthem BCBS Oncology, Rheumatology, Endocrinology, Neurology, Gastroenterology, Dermatology +1 more providers in CA on Commercial plans.

Anthem BCBS·CA · Oncology, Rheumatology, Endocrinology +4 more·Pharmacy

Effective date

Not stated

We identified it

May 3, 2026

Days to comply

—

Summary

Anthem California has expanded their specialty pharmacy precertification list, requiring additional prior authorizations for certain specialty medications. This affects billing for practices that prescribe or administer specialty pharmaceuticals, as more drugs now require approval before dispensing or administration.

Action Required

Action needed

Immediately: Review the expanded specialty pharmacy precertification list at the provided URL to identify newly added medications. Update prior authorization workflows to include these additional specialty drugs. Inform providers about new precertification requirements to prevent prescription delays and potential claim denials.

Related policy hubs

Anthem BCBS policies CA policy changes Oncology Rheumatology Endocrinology Neurology Gastroenterology Dermatology Nephrology