All PlansCoverageMedium impact
Pharmacy Medical Policy Updates
Blue Cross Blue Shield of Kansas·KS · Neurology, Pain Management, Pulmonology +3 more·Pharmacy
Effective date
May 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Kansas updated multiple pharmacy medical policies effective May 1, 2024, including coverage for Multiple Sclerosis treatments, Hereditary Angioedema, opioids, and several specialized medications. These policies are managed through Prime Therapeutics and may affect prior authorization requirements for pharmacy benefits.
Action Required
By May 1, 2024: Billing team must review updated pharmacy medical policies for Multiple Sclerosis, Hereditary Angioedema, Opioids ER, Risdiplam, Spinraza, VMAT2 Inhibitors, Xhance, PAH, Skyclarys, and Xphozah medications. Check specific medication lists and prior authorization requirements at https://www.bcbsks.com/providers/precertification-prior-authorization before prescribing or billing for these drug categories. Contact BCBSKS provider representative for clarification on coverage changes.