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Pharmacy Medical Policy Updates

Blue Cross Blue Shield of Kansas·KS · Endocrinology, Hematology, Oncology +3 more·Pharmacy
Effective date
Mar 1, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSKS has updated 9 pharmacy medical policies effective March 1, 2023, including Camzyos, Long Acting Insulin, HEMLIBRA, Human Fibrinogen Concentrate, IL-4 and IL-5 Inhibitors, Lysosomal Storage Disorders, Relyvrio, and Spevigo. These policies are managed through Prime Therapeutics and may affect prior authorization requirements for these specialty medications.

Action Required

Action needed
By March 1, 2023: Billing and clinical teams must review updated pharmacy medical policies for Camzyos, Long Acting Insulin, HEMLIBRA, Human Fibrinogen Concentrate, IL-4 Inhibitors, IL-5 Inhibitors, Lysosomal Storage Disorders, Relyvrio, and Spevigo at https://www.bcbsks.com/providers/precertification-prior-authorization. Update prior authorization workflows for these medications and verify current requirements before prescribing or billing.