CommercialPrior AuthMedium impact
Xolair (omalizumab)
Blue Cross & Blue Shield of Mississippi·MS · Allergy & Immunology, Pulmonology, Dermatology +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their prior authorization policy for Xolair (omalizumab), a specialty injectable medication used for asthma, chronic urticaria, nasal polyps, and food allergies. The policy requires prior authorization with specific criteria including age requirements, dosing limits, specialist involvement, and evidence of inadequate response to standard therapies.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Xolair (omalizumab) claims before administration. Providers must verify patient meets specific criteria including age requirements, previous therapy trials, and specialist consultation. Update billing system to flag Xolair for PA requirement. Claims submitted without prior authorization will be denied.