CommercialAdministrativeMedium impact
Medical Policy Update for March 15, 2022
Blue Cross NC·NC · Oncology, Rheumatology, Neurology +8 more·Medical Policy
Effective date
Mar 15, 2022
We identified it
Jun 16, 2026
Summary
Blue Cross NC has permanently moved numerous specialty drug policies from their Medical Policy pages to the Prior Review and Limitations page. Billing teams must now search by drug name in the 'Drugs that Need Prior Authorization' section to locate these policies, which include high-cost specialty medications like CAR-T therapy, enzyme replacement therapy, and various biologic drugs.
Action Required
Immediately: Update workflow to locate prior authorization requirements by searching drug names in Blue Cross NC's 'Drugs that Need Prior Authorization' section instead of the Medical Policy pages. Train billing staff on new location for specialty drug policies. Verify current prior auth status for all affected specialty medications before billing.