CommercialPrior AuthMedium impact
Drug Criteria Change
Arkansas Blue Cross Blue Shield·AR · Gastroenterology, Ophthalmology, Family Medicine +1 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross has updated drug criteria for four medications effective January 1, 2026. Miebo and Xiidra now have newly developed criteria for Standard, Essential, and Complete formularies. For pancreatic enzyme treatments, Pancreaze and Creon have switched positions - Pancreaze moved from target drug list to formulary alternatives, while Creon moved from formulary alternatives to target drug list for Essential and Complete plans.
Action Required
Before January 1, 2026: Billing and clinical teams must update prior authorization processes for Miebo and Xiidra under newly developed criteria for Arkansas Blue Cross Standard, Essential, and Complete plans. For pancreatic enzyme prescriptions, switch prior authorization targeting - Creon now requires prior auth for Essential and Complete plans while Pancreaze becomes the preferred alternative. Update EMR alerts and formulary references to reflect these changes.