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CommercialPrior AuthMedium impact

Pharmacy news roundup

BCBS Michigan·MI·Pharmacy
Effective date
Apr 6, 2026
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross Blue Shield of Michigan has published a pharmacy news roundup with multiple prior authorization requirements taking effect between April and July 2026. Several specialty drugs including Otarmeni, Ponlimsi, Wainua, Avlayah IV, and Kresladi IV will require prior authorization, and additional drugs will have site-of-care requirements starting July 1, 2026.

Action Required

Action needed
Immediately: Access the BCBSM provider portal at availity.com to review all pharmacy alerts. Navigate to Payer Spaces > BCBSM/BCN > Resources > Secure Provider Resources > Read Alerts > Pharmacy to view complete requirements. Before July 1, 2026: Update prior authorization workflows for Otarmeni, Ponlimsi, Wainua, Avlayah IV, Kresladi IV, and additional medical benefit drugs. Verify site-of-care requirements for affected medications. Subscribe to Provider Alerts Weekly to receive ongoing updates.