As a reminder, providers should be contacting Prime to obtain prior authorizations for in-scope drugs for our members with dates of service on or after May 1, 2026.

Providers should have began submitting medical benefit drug reviews for in-scope drugs to Prime’s Medical Pharmacy Solutions team by navigating to GatewayPA.com, or by phone at 1-833-895-8282. Drugs that are typically self-administered by the patient will continue to be requested through CoverMyMeds and/or fax.

A list of the drugs that will be needed to enter into the new platform/site will be listed in our Pharmacy Post Claim Review Medications Payment Policy.