CommercialPrior AuthMedium impact
Human Growth Hormone and Insulin-like Growth Factor-1
Blue Cross & Blue Shield of Mississippi·MS · Endocrinology, Pediatrics, Nephrology +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their prior authorization policy for Human Growth Hormone medications including Norditropin, Serostim, Increlex and others. The policy establishes detailed criteria for pediatric GH deficiency, adult GH deficiency, chronic kidney disease, HIV wasting syndrome, and severe primary IGF-1 deficiency with specific clinical requirements and renewal criteria.
Action Required
Immediately: Clinical staff must verify prior authorization requirements for all Human Growth Hormone medications (Norditropin, Serostim, Increlex, Genotropin, Humatrope, etc.) before prescribing or administering. Update EMR templates to include required documentation criteria such as IGF-1 levels, growth velocity measurements, stimulation test results, and diagnosis-specific requirements. Billing team must perform formulary drug searches using patient member ID before processing claims. Claims without proper prior authorization will be denied.