Blue Cross & Blue Shield of MississippiCommercial · Prior Auth · Medical Policy · DermatologyMedium impact
Hidradenitis Suppurativa (HS)
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Prior authorization is required for hidradenitis suppurativa (HS) treatment with Cosentyx (secukinumab), Hadlima (adalimumab-bwwd) and Simlandi (adalimumab-ryvk). Hadlima and Simlandi are the adalimumab formulary options effective 01/01/2025. Abrilada, Amjevita, Bimzelx (bimekizumab-bkzx), Cyltezo, Hulio, Humira, Hyrimoz, Idacio, Yuflyma and Yusimry are not covered on any BCBSMS Formulary. The 10/21/2026 policy history entry removed the documented Hurley Stage requirement and the documented intolerance, contraindication or hypersensitivity requirement from the initial criteria, and removed the documented clinical improvement requirement from the renewal criteria.
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01Billing team: Get prior authorization for Cosentyx (secukinumab), Hadlima (adalimumab-bwwd) or Simlandi (adalimumab-ryvk).
02Confirm the prescriber is a board certified dermatologist or has consulted with a board certified dermatologist.
03Confirm the individual is not currently being treated with another immunomodulatory agent such as a TNF-inhibitor, JAK inhibitor or IL-inhibitor.
04Confirm the prescribed dosage is within the program quantity limits based on FDA approved labeled dosage.
05Samples do not count as current or stable therapy.
06Services related to delivery and/or administration of a medication that were not approved through the BCBSMS PA review process will be considered not medically necessary.
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