CommercialPrior AuthMedium impact
Radiation oncology and radiopharmaceuticals will be managed through Oncology Value Management program, starting Sept. 1
BCBS Michigan·MI · Oncology, Radiology·Specialty Services
Effective date
Sep 1, 2026
We identified it
Jun 16, 2026
Summary
Starting September 1, 2026, radiation oncology services (including proton beam therapy) and radiopharmaceuticals will be managed through the Oncology Value Management program administered by OncoHealth instead of EviCore or Carelon. This change affects prior authorization processes for these services across most BCBS Michigan and BCN members.
Action Required
Before September 1, 2026: Billing team must update prior authorization workflows to submit radiation oncology and radiopharmaceutical requests through OncoHealth's Oncology Value Management program instead of EviCore or Carelon. Update staff training materials and contact information for prior authorization requests. Verify which self-funded groups have opted out using the provided opt-out list.