CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Apomorphine
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Family Medicine, Internal Medicine·Medical Policy
Effective date
Dec 2, 2025
We identified it
Jun 20, 2026
Summary
BCBSMS State and School Employees' Health Insurance Plan has established a new policy effective December 2, 2025, that considers Onapgo (apomorphine) for advanced Parkinson's disease motor fluctuations as NOT medically necessary. All services related to delivery and administration of this medication will be denied without prior BCBSMS approval through their review process.
Action Required
Immediately: Update billing system to flag Onapgo (apomorphine) claims for State and School Employees' Health Insurance Plan members as requiring prior authorization through BCBSMS review process. Alert providers treating advanced Parkinson's disease patients that Onapgo will be considered not medically necessary and alternative covered treatments should be considered first. All administration and delivery services for this medication will be denied without pre-approval.