CommercialPrior AuthLow impact
Actimmune (interferon gamma-1b)
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Infectious Disease, Endocrinology +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS MS updated their policy for Actimmune (interferon gamma-1b) requiring prior authorization for treatment of Chronic Granulomatous Disease and severe malignant osteopetrosis. The policy establishes specific initial and renewal criteria including specialist consultation requirements and mandatory laboratory monitoring every three months.
Action Required
Immediately: Billing team must ensure prior authorization is obtained before prescribing Actimmune (interferon gamma-1b) for patients with CGD or SMO. Verify specialist consultation requirements are met and document all required laboratory tests (CBC, differential, platelet counts, renal/liver function, urinalysis) every three months. Claims will be denied without proper prior authorization through BCBSMS PA process.