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, 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 Anthem specialty pharmacy precertification list at the provided URL to identify newly added medications requiring prior authorization. Update billing system alerts and pharmacy benefit verification processes to flag these medications. Notify providers to obtain precertification before prescribing newly listed specialty drugs to avoid claim denials.

Plan Types

Commercial

States

CA

Specialties

all-specialties