MedicaidPrior AuthMedium impact
CareFirst BlueCross BlueShield Community Health Plan Maryland Medical Drug Prior Authorization Updates
CareFirst BlueCross BlueShield·MD·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield Community Health Plan Maryland is adding new medications to their prior authorization requirement list effective April 1, 2026. The billing team must review the updated Medical Drug Prior Authorization List to identify which medications will now require prior approval before administration or prescription.
Action Required
By April 1, 2026: Billing team must review the Medical Drug Prior Authorization List at carefirst.com/medicaid and update billing system to require prior authorization for newly added medications. Notify providers of new prior auth requirements to prevent claim denials. Update encounter forms and EMR alerts for affected medications.