CommercialPrior AuthMedium impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota·ND · Oncology, Pediatrics, Gastroenterology·Pharmacy
Effective date
Jun 10, 2026
We identified it
Jun 19, 2026
Summary
BCBS North Dakota updated multiple pharmacy prior authorization policies effective June 10, 2026, including new indications for cancer treatments, pediatric expansions, retired drug policies, and standardized authorization duration requirements across all affected medications.
Action Required
Before June 10, 2026: Billing team must update prior authorization workflows for affected cancer medications (Bavencio, Imfinzi, Jemperli, Libatyo) to include new ICD-10 codes for colon, rectal, and small bowel cancers. Remove Aliqopa from formulary systems as it's been retired. Update authorization duration tracking for enzyme replacement therapies and ensure pediatric age criteria are updated for Cosentyx (12+ years) and Doptelet (1+ years). Verify NCCN guidelines compliance for oncology drug approvals.