CommercialPrior AuthMedium impact
[California] Expansion of the specialty pharmacy precertification list
Anthem BCBS·CA·Pharmacy
We identified it
May 3, 2026
Summary
Anthem has expanded their specialty pharmacy precertification list in California, adding more medications that require prior authorization before dispensing. This affects billing for specialty drugs and may delay patient treatment if precertification is not obtained.
Action Required
Immediately: Billing and clinical staff must access the updated specialty pharmacy precertification list at the provided URL to identify newly added medications. Update prior authorization workflows to include these new drugs. Verify precertification status before prescribing or billing for specialty medications to avoid claim denials and patient access delays.