Important Prior Authorization Updates - Effective October 1st, 2026

Date: 07/22/26

As part of our ongoing work to improve the prior authorization (PA) process for both providers and members, Delaware First Health wants to share some important updates to our PA requirements. Our goal is to reduce administrative burden, simplify submission and approval processes, and facilitate timely access to appropriate, high-quality care.

Code change details are noted in the table below. The changes may include:

• Removing PA requirements based on criticality of review and clinical need.
• Creating a more uniform set of prior authorization requirements across our markets and lines of businesses, including adding and changing some PA requirements, to simplify processes, reduce confusion for providers, and support future efforts to expand real-time responses to requests.

We always want to hear from you! If you notice anything missing or have suggestions for additional materials that would support your work, please let us know by submitting feedback through our Provider Feedback Form.

Need Help or Have Questions? Reach out to us through the following channels:   

1. Provider Services – 1-877-236-1341, Monday – Friday 8am – 5pm EST
2. General inquiries, email - DE_ProviderEngagement@DelawareFirstHealth.com
3. Contact your dedicated Provider Engagement Account Manager