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Blue Cross Blue Shield of North DakotaCommercial · Prior Auth · Pharmacy · ND · Oncology, PharmacyMedium impact

Pharmacy Policies Available Online

Act
by Oct 31, 2026
Effective date
Nov 1, 2026
Identified
Aug 29, 2026

Summary

Blue Cross Blue Shield of North Dakota (BCBSND) is implementing new commercial prior authorization medical drug policies effective November 1, 2026, for four specialty pharmaceutical products: Bendamustine-Avyxa, Lytenava (bevacizumab-vikg), Ponlimsi (denosumab-adet), and Tudriqev (vusolimogene oderparepvec-wtpg). Billing teams must prepare systems to require prior authorization for these drugs starting on the effective date.

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What to do

by Oct 31, 2026 · 5 steps
01Billing team must update the billing system to require prior authorization for Bendamustine-Avyxa, Lytenava (bevacizumab-vikg), Ponlimsi (denosumab-adet), and Tudriqev (vusolimogene oderparepvec-wtpg) for all BCBSND commercial plans.
02Configure system to route claims for these drugs to Gateway PA portal (www.gatewaypa.com/policydisplay/52) for approval before processing.
03Alert prescribing providers and clinical staff that prior authorization is now required for these four medications.
04Failure to obtain prior authorization will result in claim denials.
05Contact BCBSND Provider Services at 800-368-2312 for policy clarification.

Codes mentioned

J9045J9035J3396J3399

Original notice

Pharmacy Policies Available Online
bcbsnd.com · Always check the source before changing claims.
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Related changes

See all Blue Cross Blue Shield of North Dakota changes →
Pharmacy Policies Available OnlineHighNo effective date · PharmacyPharmacy Policies Available OnlineMediumEffective Dec 10, 2026 · PharmacyPharmacy Policies Available OnlineMediumNo effective date · PharmacyPharmacy Policies Available OnlineHighEffective Nov 10, 2026 · PharmacyBrowse every Blue Cross Blue Shield of North Dakota change in the policy list

Related policy hubs

Blue Cross Blue Shield of North Dakota policiesND policy changesOncologyPharmacyCode J9045Code J9035Code J3396Code J3399

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