By September 15, 2026: Billing and clinical teams must review the complete pharmacy medical policy details for each affected medication on the BCBSKS Prior Authorization (GatewayPA) page. Update billing software and EHR systems to reflect new prior authorization requirements for the 40+ affected drugs, including: Cibinqo, Otezla, Imcivree, Orals Anticoagulants, IL-13/IL-31/IL-4 agents, DPP4 inhibitors, High Cost Agents, Biologic Immunomodulators, VMAT2 Inhibitors, Weight Loss Agents, Oncology agents (Imfinzi, Opdualag, Tecentriq, Bevancio, Jemperli, Libtayo, Tecvayli, Tevimbra, Imjudo), and specialty injectables (Amvuttra, Cinqair, Datroway, Decnupaz, Denosumab, Evenity, Exdensur, Fasenra, GCSF_SA, Golimumab_IV, Hympavzi, Krystexxa, Levoleucovorin, Loqtorzi, Nucala, Onpattro, Qalsody, Rituximab_IV, Sustol, Tecentriq_IV/SQ, Tevimbra, Tezspire, Unloxcyt, Vyepti, Vyvgart_IV/SQ, Xolair, Zynyz, Leuprolide depot, Supprelin_LA, Trelstar, Triptodur, Zoladex, Zoledronic_Acid, Fosaprepitant IV, Fulvestrant, and Penpulimab-KCQX). Three medications are effective November 1, 2026 (Nereus, Fosaprepitant IV, Fulvestrant). Contact BCBSKS provider relations for clarification on specific prior authorization criteria. Failure to implement proper prior authorization will result in claim denials.