By December 15, 2026: Billing and clinical teams must implement preauthorization requirements for all non-preferred biologic products listed in Policy X.242 (denosumab, infliximab, rituximab, tocilizumab, and trastuzumab biosimilars). Update billing system and EMR to flag claims for these HCPCS codes (J0897, J1745, J3262, J3590, J9312, J9311, J9355, J9356, Q5103, Q5104, Q5112-Q5123, Q5135-Q5136, Q5156-Q5157, Q5159, Q5161-Q5162, Q5166-Q5167, Q5171, Q5173) and require prior authorization before submission. Prior to this date, providers must document contraindication, intolerance, or prior failure to preferred products on all non-preferred biologic claims for BCBSNE members. Create authorization request templates and workflows for established patients switching to non-preferred options, as step therapy now applies to both new starts and established patients. Failure to obtain prior authorization will result in claim denials.