Designated specialty pharmacy network updates

As we previously communicated, Anthem’s designated specialty pharmacy network requires providers who are not part of the designated specialty pharmacy network to acquire certain select specialty pharmacy medications administered in the hospital outpatient setting through CVS Specialty Pharmacy.

This update is to advise of the following changes:

Effective for dates of service on or after May 1, 2024, the following specialty pharmacy medications will be removed from the Designated Medical Specialty Pharmacy Drug List:

To access the current Designated Medical Specialty Pharmacy Drug List, visit anthem.com, select For Providers, select Forms and Guides (under the Provider Resources column), select your state, scroll down, and then select Pharmacy in the category dropdown. The Designated Medical Specialty Pharmacy Drug List may be updated periodically by Anthem.

If you have questions or would like to discuss the terms and conditions to be included as a designated specialty pharmacy network provider, please contact your Anthem contract manager. Thank you for your continued participation in the Anthem networks and the services you provide to our members.