CommercialPrior AuthMedium impact
Commercial Plan Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota·ND · Oncology, Ophthalmology, Endocrinology +1 more·Pharmacy
Effective date
Aug 1, 2026
We identified it
Jun 19, 2026
Summary
BCBSND is implementing new prior authorization requirements for 6 medical pharmacy drugs (including Armlupeg, Boncresa, Jubereq, Nufymco, Osvyrti, Oziltus) and new/updated utilization management programs for retail pharmacy drugs (Aqvesme, Cardamyst, Filspari) effective August 1, 2026.
Action Required
Before August 1, 2026: Billing team must update prior authorization protocols for medical pharmacy drugs Armlupeg (pegfilgrastim), Boncresa (denosumab-mobz), Jubereq (denosumab-desu), Nufymco (ranibizumab-leyk), Osvyrti (denosumab-desu), and Oziltus (denosumab-mobz). Review policy details at www.gatewaypa.com/policydisplay/52 and www.myprime.com/en/forms.html starting August 1. Update billing system alerts for these drugs to require prior authorization for BCBSND commercial patients.