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Effective January 1, seven new drugs will require prior authorization

November 06, 2018 -

Effective Jan. 1, 2019, seven medications, which are administered in the outpatient hospital and home or office settings, will be added to the prior authorization list.

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.

How to Request Prior Authorization

To submit a prior authorization online, log in to the Provider Portal at carefirst.com/providerlogin and navigate to the Prior Auth/Notifications tab to begin your request.