CommercialPrior AuthHigh impact
Medical & Pharmacy Policy Update
Blue Cross Blue Shield of Kansas·KS·Pharmacy
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Kansas has published updated medical policies for carrier screening, Vyjuvek, and bevacizumab effective 12/1/23, with additional pharmacy policy updates for GLP-1 agonists, oncology drugs, and other medications taking effect January 1, 2024. This affects prior authorization requirements and coverage determinations for multiple drug categories and medical services.
Action Required
By January 1, 2024: Billing team must review updated pharmacy policies for GLP-1 agonists, colony stimulating factors, oncology drugs, constipation agents, oral PAH medications, antidepressants, CMV treatments, Winlevi, Efgartigimod, Relyvrio, oral inhalers, pancreatic enzymes, Vyjuvek, and bevacizumab at https://www.bcbsks.com/providers/precertification-prior-authorization. Update prior authorization workflows and verify current requirements before prescribing or billing for these medications. Contact BCBSKS provider consultant for clarification on specific policy changes.