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CommercialPrior AuthLow impact

Felbatol (felbamate)

Blue Cross & Blue Shield of Mississippi·MS · Neurology, Pediatrics·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

This is an updated prior authorization policy for Felbatol (felbamate), an anti-epileptic drug. The policy requires prior authorization and specifies that patients must have failed two other anti-epileptic medications before approval, with specific age and diagnosis criteria for coverage.

Action Required

Action needed
Immediately: Billing team must ensure prior authorization is obtained before prescribing Felbatol (felbamate) for epilepsy patients. Verify patient has documented failure of two other anti-epileptic medications and meets age/diagnosis criteria. Claims will be denied without proper prior authorization.