[California] Expansion of Specialty Pharmacy Precertification List
AI 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
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.
Plan Types
Commercial
States
CA
Specialties
oncology, rheumatology, endocrinology, neurology, gastroenterology, dermatology, nephrology