CommercialPrior AuthHigh impact
Multiple Sclerosis
Blue Cross & Blue Shield of Mississippi·MS · Neurology·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi updated their Multiple Sclerosis policy requiring prior authorization for all MS disease-modifying therapies and Ampyra. The policy establishes step therapy requirements with generic agents as first-line treatment and specific trial/failure requirements for higher-tier medications.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all MS medications listed in the policy before prescribing or dispensing. Update system alerts for drugs like Avonex, Betaseron, Kesimpta, Ocrevus, Tysabri, fingolimod, dimethyl fumarate, glatiramer acetate, and teriflunomide. Providers must document step therapy trials and medical necessity. Claims will be denied without proper prior authorization.