CommercialPrior AuthMedium impact
Neonatal Fc Receptor Blockers
Blue Cross & Blue Shield of Mississippi·MS · Neurology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their policy for Neonatal Fc Receptor Blockers, adding coverage criteria for Rystiggo (rozanolixizumab-noli) with strict prior authorization requirements, while designating Vyvgart, Vyvgart Hytrulo, and Imaavy as not medically necessary. The policy requires specific antibody testing, disease severity scores, and failed conventional therapy trials.
Action Required
Immediately: Update prior authorization workflows for Neonatal Fc Receptor Blockers. Billing team must ensure Rystiggo requests include required documentation: positive anti-AChR or anti-MuSK antibodies, MGFA classification II-IV, MG-ADL score ≥6, and evidence of failed conventional therapy. Flag Vyvgart, Vyvgart Hytrulo, and Imaavy as non-covered for BCBS Mississippi. Claims without proper prior auth will be denied.