Back to dashboard
CommercialPrior AuthMedium impact

Metformin Extended-Release Formulations

Blue Cross & Blue Shield of Mississippi·MS · Family Medicine, Internal Medicine, Endocrinology·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

BCBS Mississippi updated their prior authorization policy for extended-release metformin formulations (Fortamet and Glumetza). Both medications now require prior authorization with strict step therapy requirements, including 3-month trials of other metformin products and submission of peer-reviewed literature supporting efficacy.

Action Required

Action needed
Immediately: Update prior authorization workflows for Fortamet and Glumetza prescriptions for BCBS Mississippi patients. Ensure providers document 3-month trials of immediate-release metformin and generic Glucophage XR (plus Fortamet for Glumetza requests), intolerance/failure evidence, and obtain peer-reviewed literature supporting efficacy. Add alerts in EMR for these medications requiring prior auth. Claims will be denied without proper authorization.

Related policy hubs