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CareFirst is Updating its Prior Authorization List to Include 46 New Drugs

April 19, 2018 -

CareFirst is Updating its Prior Authorization List to include 46 New Drugs Covered Under the Medical Benefit

Effective May 2, CareFirst is adding 46 drugs administered in the outpatient hospital and home or home office settings to our list of medications requiring prior authorization.

Prior authorization requests must be submitted electronically through the CareFirst Provider Portal for all drugs requiring prior authorization. To submit a prior authorization online, log in to the Provider Portal and navigate to the Prior Auth/ Notifications tab to begin your request.

Prior authorization approvals may be subject to dosing limits in accordance with FDA-approved labeling, accepted compendia, and/or evidence-based practice guidelines. Failure to obtain prior authorization for these medications may result in the denial of the claim payment.

Do you have questions?

For more information on submitting drug prior authorization electronically, view our training video or download the user guide.