If you are a NY provider that has patients on specialty drugs through a medical benefit? Then this blog post is for you!

What is changing?

• Effective DOS 4/1/26 the specialty drugs that are available through medical benefit will require a prior auth
• If your patients are already on these drugs without the auth, in order to receive a continuation the provider will need to request the prior auth

Find this blog post informative? Follow me for more!

• Highmark NY: prior authorization update- meds through medical benefit
• Partners Tailored Plan: claims dispute timely filling update
• NYS Medicaid: Dental Anesthesia
• Healthfirst coverage: CPT code 80050
• OHIO Medicaid: Billing for- ABA therapy services services