CommercialPrior AuthMedium impact
Pharmacy Authorization Updates
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Oct 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI has made changes to their pharmacy prior authorization (PA) program for commercial formularies, effective October 1, 2024. Some drugs have been moved to preferred tiers, which may affect coverage and cost-sharing for patients.
Action Required
By October 1, 2024: Billing team should review updated BCBSRI commercial formulary lists to identify which medications moved to preferred tiers. Update pharmacy benefit verification processes to reflect new prior authorization requirements. Contact BCBSRI or check their provider portal for the complete list of affected medications and updated PA requirements.