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Medicare AdvantageAdministrativeMedium impact

Obtaining Prior Authorization for Part D Drug Therapy Reviews

Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Nov 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSRI and Prime Therapeutics now offer CoverMyMeds, a free electronic prior authorization (ePA) tool for Part D drug therapy reviews, replacing manual fax and mail submissions. The electronic system integrates with EHR systems and provides faster determinations with live chat support.

Action Required

Action needed
By November 1, 2025: All staff who submit drug prior authorizations must create CoverMyMeds accounts at www.covermymeds.com and transition to using the electronic system as the primary method for Part D drug therapy review requests. Update workflow procedures to use ePA instead of fax (1-855-212-8110) or mail submissions to Prime Therapeutics.