Anthem BCBSMedium ImpactPrior Auth

[California] Anthem expands specialty pharmacy precertification list

Published May 3, 2026

AI Summary

Anthem has expanded their specialty pharmacy precertification list, adding new medications that now require prior authorization before dispensing. This affects billing for specialty pharmacy claims as additional drugs now need approval before coverage.

Action Required

Immediately: Review the expanded precertification list on Anthem's provider portal to identify newly added specialty medications. Update prior authorization workflow to include these medications. Notify providers of new requirements to prevent prescription delays and claim denials.

Plan Types

Commercial

States

CA

Specialties

all-specialties