CommercialCoverageHigh impact
New Drug Approvals and Newly Approved Indications for Currently Available Medications
Blue Cross & Blue Shield of Mississippi·MS·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBSMS updated their policy on new drug approvals and newly approved indications. All new-to-market FDA-approved drugs, biosimilars, and new indications for existing medications will be considered non-formulary/not medically necessary until reviewed by their P&T Committee. This includes related administration and delivery services.
Action Required
Immediately: Billing team must perform formulary drug searches on patient member IDs before prescribing any new FDA-approved medications or existing drugs for newly approved indications. Verify coverage status in patient's specific benefit plan. Inform providers that new drugs and new indications will likely be denied until BCBSMS P&T Committee review is complete. Update prior authorization workflows to flag new medications.