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Medicare AdvantagePrior AuthHigh impact

NextBlue of North Dakota Medicare Advantage Part B Drugs Requiring Prior Authorizations

Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Sep 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

NextBlue of North Dakota Medicare Advantage is implementing new prior authorization requirements for Part B drugs effective September 1, 2025. The updated drug list requiring prior authorization is now available on the NextBlue Provider Website under Provider Resources.

Action Required

Action needed
Before September 1, 2025: Billing team must access the NextBlue Provider Website under Provider Resources to review the updated Part B drug list requiring prior authorization. Update billing system and encounter forms to flag these drugs for prior auth. Train staff to verify authorization before administering Part B drugs to NextBlue Medicare Advantage patients. Claims will be denied without proper prior authorization.