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Preferred Product Program, Provider Directory Validation Reminder
Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Oct 3, 2026
Summary
This policy updates BCBS Wyoming's preferred product program for 2027, adding new biosimilar medications and removing others from preferred status across multiple drug classes (Bevacizumab, Rituximab, Infliximab, Viscosupplements, Ustekinumab, and new categories). Billing teams must identify affected members, update prior authorization workflows, and begin transitioning prescriptions to preferred products effective January 1, 2027, with enforcement at new authorizations and renewals.
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What to do
by Jan 1, 2027 · 5 steps
01Billing team must (1) update prior authorization workflows in Availity.com to reflect new preferred product lists and removals; (2) coordinate with providers to transition prescriptions to preferred medications listed in the 2027 column; (3) identify members currently on non-preferred medications (Gelsyn-3, Supartz, Visco-3, Steqeyma) for proactive outreach; (4) train billing staff that enforcement begins immediately at new medication prior authorizations and authorization renewals.
02Before January 1, 2027: Providers must request exceptions through prior authorization process with clinical documentation for members who cannot use preferred alternatives.
03Contact CarePath Team (307-823-6095) for member impact identification.
04Note: Ocular VEGF (Bevacizumab) requires NO prior authorization.
05Additionally, by next 90-day cycle: Confirm NPI and tax ID combinations on Availity Portal per No Surprises Act requirements.
Original notice
Preferred Product Program, Provider Directory Validation Reminder
bcbswy.com · Always check the source before changing claims.