CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Chronic Plaque Psoriasis
Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Rheumatology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
The State and School Employees' Health Insurance Plan updated their chronic plaque psoriasis policy effective January 1, 2025, removing coverage for Avsola and Renflexis while adding Inflectra as a covered biologic agent. The policy also revised prior authorization criteria for treatment history, body surface area involvement, and prescribing requirements.
Action Required
By January 1, 2025: Billing team must update prior authorization processes to exclude Avsola (infliximab-axxq) and Renflexis (infliximab-abda) as these are no longer covered. Add Inflectra (infliximab-dyyb) as a covered agent requiring prior authorization. Update encounter forms to reflect revised criteria including body surface area involvement requirements and specialist consultation documentation. Claims for non-covered agents will be denied.