CommercialPrior AuthMedium impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota·ND · Oncology, Pharmacy·Pharmacy
Effective date
Nov 1, 2026
We identified it
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.
Action Required
By October 31, 2026: Billing 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. Configure system to route claims for these drugs to Gateway PA portal (www.gatewaypa.com/policydisplay/52) for approval before processing. Alert prescribing providers and clinical staff that prior authorization is now required for these four medications. Failure to obtain prior authorization will result in claim denials. Contact BCBSND Provider Services at 800-368-2312 for policy clarification.