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January 2027 Summary of Changes - Pharmacy
Effective date
Jan 1, 2027
Identified
Nov 4, 2026
Summary
BCBS Rhode Island is updating preferred product selections for four commercial medical drug categories effective January 2027. Related prior authorization, step therapy, and policy materials will be aligned with these new preferred product selections. The specific drug categories and products are not detailed in this summary notice.
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What to do
Action · 5 steps
01Before January 1, 2027: Contact BCBS Rhode Island or review the full January 2027 pharmacy policy update (when published in full) to identify the four affected drug categories and their new preferred products.
02Update charge entry and prior authorization protocols to reflect the new preferred product selections.
03Get prior authorization before dispensing or billing non-preferred products for affected categories, as prior authorization and step therapy policies will align with the new selections.
04Tell pharmacy staff and providers about the preferred product changes for the four affected categories to avoid billing non-covered or non-preferred items.
05Watch for the payer's detailed policy materials on the four drug categories when they become available.
Original notice
January 2027 Summary of Changes - Pharmacy
bcbsri.com · Always check the source before changing claims.