Designated specialty pharmacy network updates

As previously communicated, the Designated Specialty Pharmacy Network for Anthem requires providers who are not part of it to acquire certain select specialty pharmacy medications administered in the hospital outpatient setting through CVS Specialty Pharmacy.

Updates

Effective for dates of service on and 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, please visit anthem.com/provider, select Providers, select Forms and Guides (under the Provider Resources column), select your state, scroll down, and select Pharmacy in the Category drop down. 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 care provider, please contact your contract manager with Anthem. Thank you for your continued participation in the Anthem networks and for the services you provide to our members. Beyond simply signing a contract, care providers are part of a genuine collaboration aimed at improving the lives of real people.