New Prior Authorization Requirements For Certain Provider-Administered Medications

Effective Date: Oct. 1, 2026

Health Plans Affected: Employer Health Programs (EHP)

Type of Change: Prior Authorization

Explanation of Change:

Effective Oct. 1, 2026, Johns Hopkins Health Plans will require prior authorization to determine medical necessity for select provider-administered medications under EHP. These requirements affect members of all ages.

EHP Prior Authorization Requirements October 1

For certain drug classes, EHP has a preferred drug list. These preferred drugs are indicated on the “Preferred Medical Injectable Drug List” included at the above link. The comprehensive list of provider-administered medications that require prior authorization for EHP is also available on the Johns Hopkins Health Plans website for your reference.

Submitting Medical Injectable Prior Authorization Requests:

  • Providers may submit electronic prior authorization requests through NovoLogix using the Availity secure provider portal.
  • If Availity is not available, providers may contact NovoLogix for assistance by calling 844-345-2803.