CommercialCoverageMedium impact
Spinraza (nusinersen)
Blue Cross & Blue Shield of Mississippi·MS · Neurology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Spinraza (nusinersen) policy for spinal muscular atrophy treatment. The drug does not require prior authorization, but all claims will be reviewed for medical necessity based on specific genetic testing and clinical criteria including SMN gene documentation and baseline motor function assessments.
Action Required
Immediately: For Spinraza (nusinersen) claims, ensure documentation includes genetic testing confirmation (SMN1 gene deletion/mutation), SMN2 gene copy number or symptom onset timing, baseline motor function exam results (HINE-2, HFMSE, ULM, or CHOP INTEND), and prescriber specialty verification. Claims will be reviewed for medical necessity even without prior auth requirement.