CommercialCoverageLow impact
Ztalmy (ganaxolone)
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Pediatrics·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their policy stating that Ztalmy (ganaxolone) for CDKL5 deficiency disorder seizures is considered not medically necessary because other covered treatment options are available. The policy was most recently reviewed on February 24, 2026.
Action Required
Immediately: Billing team should verify formulary coverage before prescribing Ztalmy (ganaxolone) for CDKL5 deficiency disorder patients. Use the member ID formulary search tool and explore covered alternative treatments first. For State Health Plan members, check coverage at https://www.dfa.ms.gov/cvs-caremark and submit prior authorization requests to the Pharmacy Benefit Manager if needed.