CommercialPrior AuthMedium impact
Pasireotide (Signifor® LAR)
BCBS Tennessee·TN · Endocrinology, Neurosurgery, Oncology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee has established a new medical policy for Pasireotide (Signifor LAR) requiring step therapy and prior authorization for treatment of acromegaly and Cushing's disease. The policy requires specific laboratory documentation including IGF-1 levels for acromegaly and cortisol levels for Cushing's disease, with 12-month authorization periods.
Action Required
Before July 31, 2026: Billing team must implement prior authorization requirements for Pasireotide (Signifor LAR) prescriptions. Update billing system to flag acromegaly and Cushing's disease cases requiring step therapy documentation per BCBST step therapy guide. Ensure providers document required laboratory values (IGF-1 for acromegaly, cortisol levels for Cushing's disease) and surgical history before submission. Claims without proper prior authorization will be denied.