CommercialPrior AuthMedium impact
MDR Drug Updates for July 1, 2025
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Effective July 1, 2025, certain drugs will require prior authorization (PA) from Blue Cross Blue Shield of Rhode Island. This affects pharmacy billing and requires updating authorization workflows for affected medications.
Action Required
By July 1, 2025: Billing team and providers must identify the specific drugs requiring PA from BCBSRI and update prior authorization workflows. Contact BCBSRI or check their provider portal for the complete list of affected medications. Ensure PA is obtained before dispensing or administering these drugs to avoid claim denials.