CommercialPrior AuthMedium impact
Crohn's Disease and Ulcerative Colitis
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Crohn's Disease and Ulcerative Colitis policy with specific formulary changes: Hadlima and Simlandi become the preferred adalimumab options effective 01/01/2025, and Selarsdi, Steqeyma, and Yesintek become the preferred ustekinumab options effective 08/01/2025. Multiple adalimumab and ustekinumab products are no longer covered on any BCBSMS formulary.
Action Required
By January 1, 2025: Update prior authorization requests to use preferred formulary options - Hadlima and Simlandi for adalimumab, and by August 1, 2025 use Selarsdi, Steqeyma, and Yesintek for ustekinumab. Stop requesting authorization for non-covered products including Humira, Stelara, and other listed exclusions as these will be denied. Gastroenterology providers must document step therapy requirements and conventional agent failures per the policy tables.