CommercialPrior AuthMedium impact
MDR Changes effective 10/01/2022
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island is making changes to their Medical Drug Review (MDR) program effective October 1, 2022, affecting prescription drugs covered under medical benefits. Prior authorization reviews will continue to be handled by Prime Therapeutics, their pharmacy benefits manager.
Action Required
By October 1, 2022: Billing team should verify that prior authorization processes for medical benefit drugs continue through Prime Therapeutics as pharmacy benefits manager. Monitor for any specific drug coverage changes that may affect medical billing for physician-administered medications.