CommercialCoverageMedium impact
Atypical Antipsychotics
Blue Cross & Blue Shield of Mississippi·MS · Psychiatry, Family Medicine, Internal Medicine·Medical Policy
Effective date
Jun 3, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their atypical antipsychotic policy, removing coverage for Invega, Latuda, and Saphris while maintaining that Caplyta and Secuado remain non-covered. Fanapt continues to require prior authorization with specific failure criteria for two generic atypical antipsychotics.
Action Required
By June 3, 2025: Billing team must update prior authorization protocols to reflect that Invega (paliperidone), Latuda (lurasidone), and Saphris (asenapine) are no longer covered under this policy. Verify patient formulary coverage independently and ensure Fanapt prior auths document failure of two generic atypical antipsychotics (aripiprazole, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone). Update State Health Plan members to use CVS Caremark formulary search at https://www.dfa.ms.gov/cvs-caremark.