CommercialPrior AuthMedium impact
Interleukin-5 Antagonist Monoclonal Antibodies
Blue Cross & Blue Shield of Mississippi·MS · Pulmonology, Allergy & Immunology, ENT (Ear, Nose & Throat) +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their policy for interleukin-5 antagonist monoclonal antibodies (Cinqair, Fasenra, Nucala) requiring prior authorization for multiple conditions including severe eosinophilic asthma, EGPA, chronic rhinosinusitis with nasal polyps, and hypereosinophilic syndrome. The policy includes detailed age restrictions, lab value requirements, and mandatory specialist consultation or referral.
Action Required
Immediately: Update prior authorization workflows for Cinqair (reslizumab), Fasenra (benralizumab), and Nucala (mepolizumab). Billing team must verify formulary coverage via member ID lookup before prescribing. Providers must ensure specialist consultation documentation and verify specific lab values (eosinophil counts, FEV1, FeNO) meet policy criteria before submitting prior auth requests. Claims will be denied without proper prior authorization.