CommercialPrior AuthLow impact
Pharmacy Medical Policy Updates
Blue Cross Blue Shield of Kansas·KS · Oncology·Pharmacy
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
BCBSKS has updated their pharmacy medical policy to require prior authorization with quantity limits for Vijoice (alpelisib) effective October 1, 2022. The billing team needs to ensure prior authorization is obtained for this specific medication before prescribing or dispensing.
Action Required
By October 1, 2022: Billing team must update systems to require prior authorization for Vijoice (alpelisib) prescriptions for BCBSKS patients. Notify providers that prior auth with quantity limits is required. Reference BCBSKS prior authorization page at https://www.bcbsks.com/providers/precertification-prior-authorization for specific requirements. Claims without prior authorization will be denied.