Q51691 Insurance Policy Changes

We’re adding requirements for additional medical oncology drugs for most members, starting Aug. 12

Blue Cross Blue Shield of Michigan is adding prior authorization, site of care, and step therapy requirements for 7 medical oncology drugs administered in outpatient settings, effective August 12, 2026. These drugs are managed through the Oncology Value Management program and affect commercial, Medicare Advantage, and individual plan members. Billing teams must implement new prior authorization submission workflows to OncoHealth and update internal systems to reflect these requirements before the effective date.