Back to dashboard
CommercialPrior AuthHigh impact

Pharmacy Policy Updates

Blue Cross Blue Shield of North Dakota·ND · Oncology, Gastroenterology, Rheumatology +4 more·Pharmacy
Effective date
May 12, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Dakota updated multiple pharmacy prior authorization policies effective May 12, 2026, including changes to authorization durations, new drug formulations, expanded indications for cancer treatments, and softened vaccine requirements across various medications including Aflibercept, Bevacizumab, and other specialty drugs.

Action Required

Action needed
By May 12, 2026: Billing team must update prior authorization requirements for multiple specialty drugs including Aflibercept (add new Yesafili and Ahzantive products), Bevacizumab ONCO (new combinations for ovarian cancer), Cabazitaxel (new dosing for patients 65+), and several others. Update system to reflect new authorization duration requirements that now specify exact number of days allowed. Review and update documentation requirements for vaccine administration as hard vaccine requirements have been softened. Failure to obtain proper prior authorization will result in claim denials.

Affected Billing Codes

J9999
J82.81
T80.82XA
T80.82XS
T80.89XA
T80.89XS
D59.0
D59.2