Pharmacy news roundup

REQUIREMENTS: - Immediately: Billing and clinical teams must log into the Availity provider portal (availity.com) and navigate to BCBSM/BCN Payer Spaces > Resources > Secure Provider Resources > Alerts > Pharmacy to review all linked PDF alerts and identify specific drug names and requirements. - Before Sept. 9, 2024: Implement prior authorization requirement for Boruzu for Blue Cross commercial URMBT members in billing system and pharmacy workflows. - Before Oct. 1, 2024: Implement prior authorization and/or coverage requirements for additional medical oncology drugs for most BCBSM/BCN members in pharmacy system and EMR. - Before June 15, 2024: Implement prior authorization requirement for Ranluspec for most BCBSM commercial members in pharmacy system. - Ongoing: Subscribe to Provider Alerts Weekly (link provided in policy) to receive automated weekly email notifications of future pharmacy policy changes and new effective dates. - Assign staff member to review Availity portal monthly for new pharmacy alerts to ensure compliance with all BCBSM/BCN requirements. - Update pharmacy team protocols and encounter forms to reflect prior authorization and step therapy requirements for affected medications. - Failure to implement prior authorizations will result in claim denials and treatment delays for members.