CommercialPrior AuthMedium impact
Pharmacy Program Updates: Prior Authorization Changes Effective Feb. 1, 2026
BCBS Illinois·IL · Pulmonology, Dermatology, Neurology +2 more·Prior Authorization
Effective date
Mar 15, 2026
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of Illinois is implementing new prior authorization programs and updating existing criteria for multiple specialty medications, including Arikayce, Cibinqo, Leqembi, and others. These changes affect prescription drug benefits administered by Prime Therapeutics across various plan types.
Action Required
By March 15, 2026: Billing team must update prior authorization tracking systems for Arikayce and VMAT2 inhibitors with new criteria requirements. By April 1, 2026: Add new prior authorization programs for Brensocatib, Leqembi, Rhapsido, and Vyjuvek to billing workflow. Update encounter forms and clinical staff protocols to check PA requirements before prescribing affected medications. Monitor the Prior Authorization and Step Therapy Programs page for detailed criteria updates.